Benign Tumor Mimics Papillary Thyroid Cancer; Hyalinizing Trabecular Tumor (HTT ) of the Thyroid. Pre-op Diagnosis by Genomic Marker Saves Total Thyroidectomy.
- When a nodule looks like papillary cancer on USG FNA cytopathology it usually results in a total thyroidectomy.
- Pre-op marker studies can determine the nodule is a HHT and not thyroid cancer.
- The specific marker is a PAX8-GLIS3 fusion is found in only a rare thyroid nodules cases <0.1 %.
- Because the diagnosis is highly suspicious for papillary thyroid cancer this marker may be higher due to presence of HHT.
- This leads to a false -positive DX of papillary thyroid cancer and a total thyroidectomy.
- A recent series found 5/5 with PAX8-GLIS3 fusion had HHT instead of papillary thyroid cancer.
- There are clues it is not PTC on the cytology. The presence of many inclusions is not usual with PTC but common with HHT.
- Also the trabecular pattern is also a clue.
- If you can have get genomic testing on the nodule from Dr.Nikiforov’s lab at U of Pittsburgh to look for PAX8-GLI3.
- 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.
- 310-393-8860 or [email protected]
- Reference: Nikiforova M.N. et al Thyroid 29(2) 2019 p. 161-173.