Skip to main content
Erschienen in: Strahlentherapie und Onkologie 9/2021

23.06.2021 | Case Study

Inoperable CASTLE of the thyroid gland treated with radical radiotherapy with complete remission

verfasst von: Petra Kovářová, MD, Radovan Vojtíšek, MD, PhD, Michal Krčma, MD, PhD, Prof. Ondřej Daum, MD, PhD, Prof. Jan Baxa, MD, PhD, Emília Sukovská, MD, Prof. Jindřich Fínek, MD, PhD, MHA

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 9/2021

Einloggen, um Zugang zu erhalten

Abstract

Carcinoma showing thymus-like elements (CASTLE) is an extremely rare malignant tumor of the thyroid gland and soft tissues of the neck with favorable prognosis. Histological features of the CASTLE are similar to thymic carcinoma, and it is assumed that it arises from the ectopic thymic tissue or the remnants of branchial pouches. The optimal treatment strategy is still uncertain because of the rarity of the tumor. The mainstay of treatment is surgery. The role of other modalities is unclear. We present a case report of a patient with locally advanced CASTLE of the thyroid gland who was not suitable for surgery and underwent radical radiotherapy with subsequent achievement of complete remission. We also present a literature review.
Literatur
1.
Zurück zum Zitat Wong EHC, Tetter N, Tzankov A, Muller L (2018) CASTLE tumor of the parotid: first documented case, literature review, and genetic analysis of the cancer. Head Neck 40(1):E1–E4CrossRef Wong EHC, Tetter N, Tzankov A, Muller L (2018) CASTLE tumor of the parotid: first documented case, literature review, and genetic analysis of the cancer. Head Neck 40(1):E1–E4CrossRef
2.
Zurück zum Zitat Zhang G, Liu X, Huang W et al (2015) Carcinoma showing thymus-like elements of the thyroid gland: report of three cases including one case with breast cancer history. Pathol Oncol Res 21(1):45–51CrossRef Zhang G, Liu X, Huang W et al (2015) Carcinoma showing thymus-like elements of the thyroid gland: report of three cases including one case with breast cancer history. Pathol Oncol Res 21(1):45–51CrossRef
3.
Zurück zum Zitat Chan JK, Rosai J (1991) Tumors of the neck showing thymic or related branchial pouch differentiation: a unifying concept. Hum Pathol 22(4):349–367CrossRef Chan JK, Rosai J (1991) Tumors of the neck showing thymic or related branchial pouch differentiation: a unifying concept. Hum Pathol 22(4):349–367CrossRef
4.
Zurück zum Zitat Miyauchi A, Kuma K, Matsuzuka F et al (1985) Intrathyroidal epithelial thymoma: an entity distinct from squamous cell carcinoma of the thyroid. World J Surg 9(1):128–135CrossRef Miyauchi A, Kuma K, Matsuzuka F et al (1985) Intrathyroidal epithelial thymoma: an entity distinct from squamous cell carcinoma of the thyroid. World J Surg 9(1):128–135CrossRef
5.
Zurück zum Zitat Robbins KT, Shaha AR, Medina JE et al (2008) Consensus statement on the classification and terminology of neck dissection. Arch Otolaryngol Head Neck Surg 134(5):536–538CrossRef Robbins KT, Shaha AR, Medina JE et al (2008) Consensus statement on the classification and terminology of neck dissection. Arch Otolaryngol Head Neck Surg 134(5):536–538CrossRef
6.
Zurück zum Zitat Gao R, Jia X, Ji T et al (2018) Management and prognostic factors for thyroid carcinoma showing thymus-like elements (CASTLE): a case series study. Front Oncol 8:477CrossRef Gao R, Jia X, Ji T et al (2018) Management and prognostic factors for thyroid carcinoma showing thymus-like elements (CASTLE): a case series study. Front Oncol 8:477CrossRef
7.
Zurück zum Zitat Luo CM, Hsueh C, Chen TM (2005) Extrathyroid carcinoma showing thymus-like differentiation (CASTLE) tumor‑a new case report and review of literature. Head Neck 27(10):927–933CrossRef Luo CM, Hsueh C, Chen TM (2005) Extrathyroid carcinoma showing thymus-like differentiation (CASTLE) tumor‑a new case report and review of literature. Head Neck 27(10):927–933CrossRef
8.
Zurück zum Zitat Cheuk W, Chan JKC, Dorfman DM, Giordano T (2004) Carcinoma showing thymus-like differentiation. In: Delellis RA, Lloyd RV, Heitz PU, Eng C (eds) Pathology and genetics of tumours of endocrine organs. IARC Press, Lyon, pp 96–97 Cheuk W, Chan JKC, Dorfman DM, Giordano T (2004) Carcinoma showing thymus-like differentiation. In: Delellis RA, Lloyd RV, Heitz PU, Eng C (eds) Pathology and genetics of tumours of endocrine organs. IARC Press, Lyon, pp 96–97
9.
Zurück zum Zitat Patil VR, Patel K, Muzumdar G (2016) Carcinoma showing thymus like differentiation (CASTLE)—A rare thyroid neoplasm. Thyroid Res Pract 13:71–73CrossRef Patil VR, Patel K, Muzumdar G (2016) Carcinoma showing thymus like differentiation (CASTLE)—A rare thyroid neoplasm. Thyroid Res Pract 13:71–73CrossRef
10.
Zurück zum Zitat Ito Y, Miyauchi A, Nakamura Y et al (2007) Clinicopathologic significance of intrathyroidal epithelial thymoma/carcinoma showing thymus-like differentiation: a collaborative study with Member Institutes of The Japanese Society of Thyroid Surgery. Am J Clin Pathol 127(2):230–236CrossRef Ito Y, Miyauchi A, Nakamura Y et al (2007) Clinicopathologic significance of intrathyroidal epithelial thymoma/carcinoma showing thymus-like differentiation: a collaborative study with Member Institutes of The Japanese Society of Thyroid Surgery. Am J Clin Pathol 127(2):230–236CrossRef
12.
Zurück zum Zitat Ge W, Yao YZ, Chen G, Ding YT (2016) Clinical analysis of 82 cases of carcinoma showing thymus-like differentiation of the thyroid. Oncol Lett 11(2):1321–1326CrossRef Ge W, Yao YZ, Chen G, Ding YT (2016) Clinical analysis of 82 cases of carcinoma showing thymus-like differentiation of the thyroid. Oncol Lett 11(2):1321–1326CrossRef
13.
Zurück zum Zitat Wu B, Sun T, Gu Y et al (2016) CT and MR imaging of thyroid carcinoma showing thymus-like differentiation (CASTLE): a report of ten cases. Br J Radiol 89(1060):20150726CrossRef Wu B, Sun T, Gu Y et al (2016) CT and MR imaging of thyroid carcinoma showing thymus-like differentiation (CASTLE): a report of ten cases. Br J Radiol 89(1060):20150726CrossRef
14.
Zurück zum Zitat Liu Z, Teng XY, Sun DX et al (2013) Clinical analysis of thyroid carcinoma showing thymus-like differentiation: report of 8 cases. Int Surg 98(2):95–100CrossRef Liu Z, Teng XY, Sun DX et al (2013) Clinical analysis of thyroid carcinoma showing thymus-like differentiation: report of 8 cases. Int Surg 98(2):95–100CrossRef
15.
Zurück zum Zitat Kusada N, Hara Y, Kobayashi S et al (2005) A case of aggressive carcinoma showing thymus-like differentiation with distant metastases. Thyroid 15(12):1383–1388CrossRef Kusada N, Hara Y, Kobayashi S et al (2005) A case of aggressive carcinoma showing thymus-like differentiation with distant metastases. Thyroid 15(12):1383–1388CrossRef
16.
Zurück zum Zitat Luo CM, Hsueh C, Chen TM (2005) Extrathyroid carcinoma showing thymus-like differentiation (CASTLE) tumor—A new case report and review of literature. Head Neck 27(10):927–933CrossRef Luo CM, Hsueh C, Chen TM (2005) Extrathyroid carcinoma showing thymus-like differentiation (CASTLE) tumor—A new case report and review of literature. Head Neck 27(10):927–933CrossRef
17.
Zurück zum Zitat Bayer-Garner IB, Kozovska ME, Schwartz MR, Reed JA (2004) Carcinoma with thymus-like differentiation arising in the dermis of the head and neck. J Cutan Pathol 31(9):625–629CrossRef Bayer-Garner IB, Kozovska ME, Schwartz MR, Reed JA (2004) Carcinoma with thymus-like differentiation arising in the dermis of the head and neck. J Cutan Pathol 31(9):625–629CrossRef
18.
Zurück zum Zitat Häfner M, Roeder F, Sterzing F et al (2015) Postoperative radiotherapy of patients with thymic epithelial tumors (TET). Strahlenther Onkol 191:133–140CrossRef Häfner M, Roeder F, Sterzing F et al (2015) Postoperative radiotherapy of patients with thymic epithelial tumors (TET). Strahlenther Onkol 191:133–140CrossRef
19.
Zurück zum Zitat Fung ACH, Tsang JS, Lang BHH (2019) Thyroid carcinoma showing thymus-like differentiation (CASTLE) with tracheal invasion: a case report. Am J Case Rep 10(20):1845–1851CrossRef Fung ACH, Tsang JS, Lang BHH (2019) Thyroid carcinoma showing thymus-like differentiation (CASTLE) with tracheal invasion: a case report. Am J Case Rep 10(20):1845–1851CrossRef
20.
Zurück zum Zitat Kong F, Ying H, Zhai R et al (2016) Clinical outcome of intensity modulated radiotherapy for carcinoma showing thymus-like differentiation. Oncotarget 7(49):81899–81905CrossRef Kong F, Ying H, Zhai R et al (2016) Clinical outcome of intensity modulated radiotherapy for carcinoma showing thymus-like differentiation. Oncotarget 7(49):81899–81905CrossRef
21.
Zurück zum Zitat Chow SM, Chan JK, Tse LL et al (2007) Carcinoma showing thymus-like element (CASTLE) of thyroid: combined modality treatment in 3 patients with locally advanced disease. Eur J Surg Oncol 33(1):83–85CrossRef Chow SM, Chan JK, Tse LL et al (2007) Carcinoma showing thymus-like element (CASTLE) of thyroid: combined modality treatment in 3 patients with locally advanced disease. Eur J Surg Oncol 33(1):83–85CrossRef
22.
Zurück zum Zitat Kropf J, Castaneira G, Luc LT et al (2019) A case of thymic carcinoma with bone and cerebral metastases treated with stereotactic radiosurgery and chemotherapy. Am J Case Rep 20:1669–1674CrossRef Kropf J, Castaneira G, Luc LT et al (2019) A case of thymic carcinoma with bone and cerebral metastases treated with stereotactic radiosurgery and chemotherapy. Am J Case Rep 20:1669–1674CrossRef
23.
Zurück zum Zitat Tsutsui H, Hoshi M, Kubota M et al (2013) Management of thyroid carcinoma showing thymus-like differentiation (CASTLE) invading the trachea. Surg Today 43(11):1261–1268CrossRef Tsutsui H, Hoshi M, Kubota M et al (2013) Management of thyroid carcinoma showing thymus-like differentiation (CASTLE) invading the trachea. Surg Today 43(11):1261–1268CrossRef
25.
Zurück zum Zitat Roka S, Kornek G, Schüller J et al (2004) Carcinoma showing thymic-like elements—A rare malignancy of the thyroid gland. Br J Surg 91(2):142–145CrossRef Roka S, Kornek G, Schüller J et al (2004) Carcinoma showing thymic-like elements—A rare malignancy of the thyroid gland. Br J Surg 91(2):142–145CrossRef
26.
Zurück zum Zitat Hanamura T, Ito K, Uehara T et al (2015) Chemosensitivity in carcinoma showing thymus-like differentiation: a case report and review of the literature. Thyroid 25(8):969–972CrossRef Hanamura T, Ito K, Uehara T et al (2015) Chemosensitivity in carcinoma showing thymus-like differentiation: a case report and review of the literature. Thyroid 25(8):969–972CrossRef
27.
Zurück zum Zitat Kelly RJ, Petrini I, Rajan A et al (2011) Thymic malignancies: from clinical management to targeted therapies. J Clin Oncol 29(36):4820–4827CrossRef Kelly RJ, Petrini I, Rajan A et al (2011) Thymic malignancies: from clinical management to targeted therapies. J Clin Oncol 29(36):4820–4827CrossRef
28.
Zurück zum Zitat Weissferdt A, Fujimoto J, Kalhor N et al (2017) Expression of PD‑1 and PD-L1 in thymic epithelial neoplasms. Mod Pathol 30(6):826–833CrossRef Weissferdt A, Fujimoto J, Kalhor N et al (2017) Expression of PD‑1 and PD-L1 in thymic epithelial neoplasms. Mod Pathol 30(6):826–833CrossRef
Metadaten
Titel
Inoperable CASTLE of the thyroid gland treated with radical radiotherapy with complete remission
verfasst von
Petra Kovářová, MD
Radovan Vojtíšek, MD, PhD
Michal Krčma, MD, PhD
Prof. Ondřej Daum, MD, PhD
Prof. Jan Baxa, MD, PhD
Emília Sukovská, MD
Prof. Jindřich Fínek, MD, PhD, MHA
Publikationsdatum
23.06.2021
Verlag
Springer Berlin Heidelberg
Erschienen in
Strahlentherapie und Onkologie / Ausgabe 9/2021
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-021-01800-6

Weitere Artikel der Ausgabe 9/2021

Strahlentherapie und Onkologie 9/2021 Zur Ausgabe

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.