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Case Reports in Pathology
Volume 2014, Article ID 301780, 4 pages
http://dx.doi.org/10.1155/2014/301780
Case Report

Primary Squamous Cell Carcinoma of the Thyroid Diagnosed as Anaplastic Carcinoma: Failure in Fine-Needle Aspiration Cytology?

1Division of Endocrinology and Metabolism, Internal Medicine Department, Botucatu Medical School, São Paulo State University (UNESP), 18618-000 Botucatu, SP, Brazil
2Pathology Department, Botucatu Medical School, São Paulo State University (UNESP), 18618-000 Botucatu, SP, Brazil
3Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), 4200-465 Porto, Portugal
4Head and Neck Department, Botucatu Medical School, São Paulo State University (UNESP), 18618-000 Botucatu, SP, Brazil
5Division of Clinical Oncology, Internal Medicine Department, Botucatu Medical School, São Paulo State University (UNESP), 18618-000 Botucatu, SP, Brazil
6Division of Radiotherapy, Department of Dermatology and Radiotherapy, Botucatu Medical School, São Paulo State University (UNESP), 18618-000 Botucatu, SP, Brazil
7Division of Endocrinology and Metabolism, Internal Medicine Department, Botucatu Medical School (FMB), São Paulo State University (UNESP), 18618-000 Botucatu, SP, Brazil

Received 23 May 2014; Accepted 20 August 2014; Published 9 September 2014

Academic Editor: Tanja Batinac

Copyright © 2014 Fernanda Bolfi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A case of primary squamous-cell carcinoma (SCC) of the thyroid which had been initially diagnosed as an anaplastic carcinoma (ATC) is described: female, 73 years old, with a fast-growing cervical nodule on the left side and hoarseness for 3 months. Ultrasonography showed a 4.5 cm solid nodule. FNA was compatible with poorly differentiated carcinoma with immunoreactivity for AE1/AE3, EMA. Thyroidectomy was performed. Histopathological examination showed a nonencapsulated tumor. Immunohistochemistry disclosed positivity for AE1/AE3, p53,p63, and Ki67. The diagnosis was ATC. A second opinion reported tumor consisting of squamous cells, with intense inflammatory infiltrate both in tumor and in the adjacent thyroid, with final diagnosis of SCC, associated with Hashimoto thyroiditis. No other primary focus of SCC was found. Patient has shown a 48-month survival period. Clinically, primary SCCs of the thyroid and ATCs are similar. The distinction is often difficult particularly when based on the cytological analysis of FNA material.