Synchronous thyroid carcinomas (STCs), including those with medullary thyroid carcinoma (MTC), display a range of different features and prognoses depending on several factors such as which carcinoma subtypes are involved, according to a retrospective study published in Endocrine.

Patients with synchronous anaplastic and differentiated thyroid carcinomas (SADTC) had significantly worse overall survival than patients in the other STC groups (P <.01), including synchronous differentiated and differentiated thyroid carcinoma (SDDTC) and synchronous medullary and differentiated thyroid carcinoma (SMDTC).

“There are significant differences in clinical features and histological manifestations of different pathological types of thyroid cancer. Their coexistence in the same patient is a very rare event, and although related cases have been reported, to our knowledge this is the first large cohort study of such cases with long-term follow-up,” the authors said.


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Multivariate analysis using Cox regression models found that cervical lateral lymph node metastasis and a tumor stage of III/IV were possible prognostic factors affecting progression-free survival (PFS) of the full cohort. No statistically significant difference in PFS was observed between 3 different groups of STCs (P =.081), however.

The majority of patients with STC in the study were female (59 out of 68 patients), however, there was no significant difference in sex between the subgroups (P =1.00). The patients in the SADTC group had significantly longer disease durations and maximum tumor diameters than those in the other subtype groups.

During follow-up, 6 patients died, including 4 patients with SADTC (50%) and 2 patients with SDDTC (4.8%). No patients in the SMDTC group died during the follow-up period. All 8 of the patients with SADTC in the study had stage III/IV tumors, which was significantly higher than the number of patients in the other 2 synchronous tumor groups (both P <.01).

Sixty-eight patients with STC were recruited for this retrospective study between January 2013 and December 2021. All patients underwent surgical resection of their tumors, and the synchronous subgroups were determined using postoperative pathology and included 42 patients with SDDTC, 18 patients with SMDTC, and 8 patients with SADTC.

Reference

Dai Q, Fu X, Ding Y, He Q, Qiu X. Clinicopathological features and prognostic factors analysis of multiple synchronous distinct subtypes of primary thyroid carcinoma. Endocrine. Published online November 18, 2022. doi:10.1007/s12020-022-03243-0