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© 2019. This work is published under NOCC (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Although papillary thyroid carcinoma (PTC)-type nuclear changes are the most reliable morphological feature in the diagnosis of PTC, the nuclear assessment used to identify these changes is highly subjective. Here, we report a noninvasive encapsulated thyroid tumor with a papillary growth pattern measuring 23 mm at its largest diameter with a nuclear score of 2 in a 26-year-old man. After undergoing left lobectomy, the patient was diagnosed with an encapsulated PTC. However, a second opinion consultation suggested an alternative diagnosis of follicular adenoma with papillary hyperplasia. When providing a third opinion, we identified a low MIB-1 labeling index and a heterozygous point mutation in the KRAS gene but not the BRAF gene. We speculated that this case is an example of a novel borderline tumor with a papillary structure. Introduction of the new terminology "noninvasive encapsulated papillary RAS-like thyroid tumor (NEPRAS)" without the word "cancer" might relieve the psychological burden of patients in a way similar to the phrase "noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP)."

Details

Title
Encapsulated Papillary Thyroid Tumor with Delicate Nuclear Changes and a KRAS Mutation as a Possible Novel Subtype of Borderline Tumor
Author
Ohba, Kenji 1 ; Mitsutake, Norisato 2 ; Matsuse, Michiko 2 ; Rogounovitch, Tatiana 2 ; Nishino, Nobuhiko 3 ; Oki, Yutaka; Goto, Yoshie; Kakudo, Kennichi

 Department of Internal Medicine, Enshu Hospital, Shizuoka 
 Department of Radiation Medical Sciences, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki 
 Department of Surgzery, Maruyama Hospital, Shizuoka 
Pages
136-141
Section
CASE STUDY
Publication year
2019
Publication date
Mar 2019
Publisher
Korean Society of Pathologists, Korean Society for Cytopathology
ISSN
23837837
e-ISSN
23837845
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2199073678
Copyright
© 2019. This work is published under NOCC (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.