Benign Tumor Mimics Papillary Thyroid Cancer; Hyalinizing Trabecular Tumor (HTT ) of the Thyroid. Pre-op Diagnosis by Genomic Marker Saves Total Thyroidectomy.

Benign Tumor Mimics Papillary Thyroid Cancer; Hyalinizing Trabecular Tumor (HTT ) of the Thyroid. Pre-op Diagnosis by Genomic Marker Saves Total Thyroidectomy.

Benign Tumor Mimics Papillary Thyroid Cancer; Hyalinizing Trabecular Tumor (HTT ) of the Thyroid. Pre-op Diagnosis by Genomic Marker Saves Total Thyroidectomy.

Benign Tumor Mimics Papillary Thyroid Cancer; Hyalinizing Trabecular Tumor (HTT ) of the Thyroid. Pre-op Diagnosis by Genomic Marker Saves Total Thyroidectomy.

 

Dr.Guttler’s Comments:

  1. When a nodule looks like papillary cancer on USG FNA cytopathology it usually results in a total thyroidectomy.
  2. Pre-op marker studies can determine the nodule is a HHT and not thyroid cancer.
  3. The specific marker is a PAX8-GLIS3 fusion is found in only a rare thyroid nodules cases <0.1 %.
  4. Because the diagnosis is highly suspicious for papillary thyroid cancer this marker may be higher due to presence of HHT.
  5. This leads to a false -positive DX of papillary thyroid cancer and a total thyroidectomy.
  6. A recent series found 5/5 with PAX8-GLIS3 fusion had HHT instead of papillary thyroid cancer.
  7. There are clues it is not PTC on the cytology. The presence of many inclusions is not usual with PTC but common with HHT.
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  9. Also the trabecular pattern is also a clue.
  10. If you can have get genomic testing on the nodule from Dr.Nikiforov’s lab at U of Pittsburgh to look for PAX8-GLI3.
  11. Call me for details how to see me before the surgery to save you from a total thyroidectomy if you are told it is a papillary thyroid cancer. It could be HHT.
  12. 310-393-8860 or thyroid.manager@protonmail.com.
  13. Dr.G.
  14. Reference: Nikiforova M.N. et al Thyroid 29(2) 2019 p. 161-173.
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