Primary angiosarcoma of the thyroid gland with recurrence diagnosed by fine needle aspiration: a case report

Isa, Nurismah Md., James, Daniel T., Saw, Teong H., Pennisi, Robert and Gough, Ian (2009) Primary angiosarcoma of the thyroid gland with recurrence diagnosed by fine needle aspiration: a case report. Diagnostic Cytopathology, 37 6: 427-432. doi:10.1002/dc.21065

Author Isa, Nurismah Md.
James, Daniel T.
Saw, Teong H.
Pennisi, Robert
Gough, Ian
Title Primary angiosarcoma of the thyroid gland with recurrence diagnosed by fine needle aspiration: a case report
Journal name Diagnostic Cytopathology   Check publisher's open access policy
ISSN 8755-1039
Publication date 2009-06
Sub-type Article (original research)
DOI 10.1002/dc.21065
Volume 37
Issue 6
Start page 427
End page 432
Total pages 6
Place of publication Hoboken, NJ, United States
Publisher John Wiley & Sons
Language eng
Abstract Angiosarcoma of the thyroid is a rare and aggressive primary malignant tumor of the thyroid originally reported in patients from the Swiss Alpine region. Diagnosis of this tumor rests mainly on characteristic histopathological features of a malignant vascular tumor supported by immunopositivity for vascular markers e.g., CD31, Factor VIII, and CD34. Its cytological features, however, are not well-defined. We describe a case of primary angiosarcoma of the thyroid in a 48-year-old female, who presented with a rapidly enlarging neck mass associated with compressive symptoms. She had a history of hypothyroidism. The initial fine needle aspiration cytology of the neck mass was negative. She then underwent left hemithyroidectomy. Histologically, the tumor showed poorly differentiated malignant cells with eccentrically-placed nuclei, prominent nucleoli, and intracytoplasmic vacuoles admixed with mixed inflammatory cells. These showed immunopositivity for CD31 but were negative for CD34, Factor VIII, CK5/6, EMA, TTF-1, Thyroglobulin, Calcitonin, Melan A, and Calretinin. A diagnosis of poorly differentiated malignant tumor consistent with angiosarcoma was made. The patient was treated with radiation therapy but developed recurrence of the tumor. Second aspiration cytology of the recurrent tumor yielded hypocellular smears containing singularly dispersed atypical cells having eccentrically-placed nuclei with prominent macronucleoli and intracytoplasmic vacuoles within a background of inflammatory cells, consistent with recurrent angiosarcoma. Chemotherapy was started but she succumbed to the disease 7 months after diagnosis. The cytological, histopathological, immunohistochemical findings, and the clinical course are discussed.
Keyword Angiosarcoma
Fine needle aspiration cytology
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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