Cases for meeting Dr Bin Xu and Dr Ronald Ghossein
Dr Bin Xu
Case 1. 68-year-old male, 3.5 cm left retromandibular mass. Negative for HHF35, MDM2, CDK4, desmin, S100, SOX10, CAM5.2, and pan-cytokeratin, diagnosed as spindle cell sarcoma, NOS at two tertiary centers. Next generation sequencing shows BRAF V600E, TERT promoter, and PTEN mutations. Patient has a remote history of papillary thyroid carcinoma s/p total thyroidectomy and RAI 17 years ago.
Case 2. 17-year-old boy, neck swelling. MXD4::NUTM1 fusion
Case 3. 15-year-old girl, 4-month history of rapid enlarging thyroid mass (3.8 cm). Positive for: HMWCK, Synaptophysin (patchy), CD56 (patchy), p63, CKIT and CD5, negative for NUT, thyroglobulin, calcitonin, TdT, PTH, chromogranin, CEA, S100, desmin, WT-1, myogenin, and myoD1.
Case 5. 43-year-old female, 4.4 cm thyroid mass. She developed lung metastasis in 1 year. RBM10::TFE3 fusion
Dr Ronald Ghossein
Case 4. 66 year old female with a 6.4 cm dominant mass in the mid and lower pole of right thyroid lobe with caudal extension into superior mediastinum. Total thyroidectomy with mediastinal mass resection. Right lymph node dissection
Case 7. 29 year old male, previously healthy, one month before diagnosis noticed tightness around his neck while trying to button his shirt. Total thyroidectomy, right neck and central compartment neck dissection
Case 1. 22/22652. Female 17y old. Right thyroid nodule. FNA Thy4.
Case 2. 22/24518. Male 52y old. Left thyroid nodule. FNA x2 Thy1.
Case 3. CH 34178/22. Male 53 years old. 2WW referral with solitary thyroid nodule and unexplained hoarseness of voice change and dysphagia. O/E left thyroid nodule, no lymphadenopathy. US showed two nodules in the left lobe of the thyroid, both were well defined and mildly hypoechoic (U4- suspicious), Thy 3f cytology
Case 4. 22/1421. Female 69. Left thyroid nodule. U3/U4
Case 5. CH 2651/22. 77y old female, right U3 Thy 4 thyroid nodule. Thyrotoxic. Right thyroid lobe 55x30x24mm with isthmus. Well circumscribed nodule with fairly homogeneous yellow cut surface with thin capsule maximally 30mm in size
Case 6. CH 13674/22. 56 year old female, left sided thyroid nodule for 4 years as T3 toxicosis. US MNG & dominant left lobe nodule which increased in size slightly. Thy 2 cytology x2
Case 7. 22/15239. 64 year male. Right thyroid nodule. FNA Thy 3a. ?Hashimoto's thyroiditis.
Case 8. 53 year old female, previous L lobectomy for benign disease 15 y ago. Now Thy 3a nodule in right lobe. R. hemithyroidectomy 30x28mm circumscribed white nodule. Background thyroid shows few goitrous nodules. Other relevant IHC; negative for calcitonin, CEA, CD34, SMA, desmin & S100.