Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma: A Single-Center Case Series of Five Patients.

IF 2.8 4区医学 Q3 BIOTECHNOLOGY & APPLIED MICROBIOLOGY

OncoTargets and therapy Pub Date : 2026-04-07 eCollection Date: 2026-01-01 DOI:10.2147/OTT.S595202

XiaoYu Sun, Yanze Liu, Jie Peng, Jiaqi Liu

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引用次数: 0

Abstract

Background: Diffuse sclerosing variant papillary thyroid carcinoma (DSVPTC) is a rare subtype of papillary thyroid carcinoma characterized by diffuse intrathyroidal involvement and frequent cervical lymph node metastasis. This study aims to delineate the clinicopathologic features, treatment outcomes, and recurrence patterns of DSVPTC.

Methods: We retrospectively reviewed five patients with histopathologically confirmed DSVPTC treated at Zibo Central Hospital between 2009 and 2025. Follow-up data were collected until December 30, 2025.

Results: Patients were aged 22-54 years (median: 41 years) and 60% (3/5) were female. Hashimoto's thyroiditis was present in 80% (4/5). All patients presented with diffuse microcalcifications on ultrasound (100%, 5/5). Thyroid FNA was performed in 80% (4/5) and all aspirates were Bethesda category VI. Cervical lymph node metastasis was observed in all patients: central compartment in 100% (5/5) and lateral neck in 60% (3/5). TNM staging (8th edition) included: pT1aN1aM0 (n=1), pT1aN1bM0 (n=1), pT3bN1aM0 (n=1), pT3bN1bM0 (n=2). According to ATA risk stratification, 3 patients were classified as high risk and 2 as intermediate risk. All patients underwent total thyroidectomy with bilateral central neck dissection. Lateral neck dissection was performed in 3 patients with radiologic evidence of lateral nodal disease. All patients received TSH suppression therapy (TSH <0.1 mIU/L) and two courses of I-131 therapy (100 mCi per course) at 3 and 6 months postoperatively. With a median follow-up of 2 years (range: 1-16 years), structural recurrence occurred in 2 patients (40%, 2/5) in the ipsilateral lateral neck at 1 and 4 years, respectively. No distant metastasis or disease-specific death occurred.

Conclusion: In this small series of five patients, DSVPTC commonly presented as a nodule-negative "snowstorm" microcalcification phenotype with high nodal burden. Despite aggressive multimodal therapy including total thyroidectomy, TSH suppression, and scheduled radioiodine, lateral neck recurrence occurred in 40% of patients. Meticulous preoperative lateral neck assessment and long-term imaging-based surveillance remain essential.

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弥漫性硬化型甲状腺乳头状癌：5例单中心病例系列。

背景：弥漫性硬化变异性甲状腺乳头状癌（DSVPTC）是一种罕见的甲状腺乳头状癌亚型，其特征是弥漫性甲状腺内受累和频繁的颈部淋巴结转移。本研究旨在描述DSVPTC的临床病理特征、治疗结果和复发模式。方法：回顾性分析2009年至2025年在淄博市中心医院经组织病理学证实的5例DSVPTC患者。随访数据收集至2025年12月30日。结果：患者年龄22 ~ 54岁（中位41岁），女性占60%（3/5）。80%（4/5）存在桥本甲状腺炎。所有患者超声均表现为弥漫性微钙化（100%,5/5）。80%（4/5）患者行甲状腺FNA，所有抽吸物均为Bethesda VI类。所有患者均观察到颈部淋巴结转移：中央室100%(5/5)，颈部外侧60%（3/5）。TNM分期（第8版）包括：pT1aN1aM0 （n=1）、pT1aN1bM0 （n=1）、pT3bN1aM0 （n=1）、pT3bN1bM0 （n=2）。根据ATA危险分层，高危3例，中危2例。所有患者均行甲状腺全切除术并双侧中央颈部清扫术。3例有侧淋巴结病变的患者行侧颈清扫术。结论：在这5例患者中，DSVPTC通常表现为结节阴性的“暴风雪”微钙化表型，伴有高结节负担。尽管积极的多模式治疗包括全甲状腺切除术、抑制TSH和定期放射性碘，但40%的患者发生了侧颈复发。精细的术前侧颈评估和长期影像学监测仍然是必不可少的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

OncoTargets and therapy BIOTECHNOLOGY & APPLIED MICROBIOLOGY-ONCOLOGY

CiteScore

9.70

自引率

0.00%

发文量

221

审稿时长

1 months

期刊介绍： OncoTargets and Therapy is an international, peer-reviewed journal focusing on molecular aspects of cancer research, that is, the molecular diagnosis of and targeted molecular or precision therapy for all types of cancer. The journal is characterized by the rapid reporting of high-quality original research, basic science, reviews and evaluations, expert opinion and commentary that shed novel insight on a cancer or cancer subtype. Specific topics covered by the journal include: -Novel therapeutic targets and innovative agents -Novel therapeutic regimens for improved benefit and/or decreased side effects -Early stage clinical trials Further considerations when submitting to OncoTargets and Therapy: -Studies containing in vivo animal model data will be considered favorably. -Tissue microarray analyses will not be considered except in cases where they are supported by comprehensive biological studies involving multiple cell lines. -Biomarker association studies will be considered only when validated by comprehensive in vitro data and analysis of human tissue samples. -Studies utilizing publicly available data (e.g. GWAS/TCGA/GEO etc.) should add to the body of knowledge about a specific disease or relevant phenotype and must be validated using the authors’ own data through replication in an independent sample set and functional follow-up. -Bioinformatics studies must be validated using the authors’ own data through replication in an independent sample set and functional follow-up. -Single nucleotide polymorphism (SNP) studies will not be considered.