ABSTRACT
BACKGROUND: Mixed medullary and follicular cell-derived thyroid carcinoma (MMFCC) is characterized by the coexistence of follicular and C cell-derived tumour cell populations within the same lesion. Due to its rarity, its etiology and clinical course remain unclear, and treatment for advanced or recurrent cases has not been established. CASE PRESENTATION: We report a case of MMFCC treated with selpercatinib. The patient was a 69-year-old male presenting with tumors in the right thyroid lobe and in the upper mediastinum. Fine-needle aspiration (FNA) cytology of the right thyroid lobe tumor revealed a medullary carcinoma; germline RET mutations were not detected. After resection of the right thyroid lobe with central node dissection, rapid intraoperative diagnosis of the mediastinal mass confirmed malignancy, leading to total thyroidectomy with excision of the upper mediastinal tumor. Histologically, the tumor in the right thyroid lobe and the pretracheal lymph node revealed a mixture of medullary and follicular carcinoma components, diagnosed as MMFCC. The mediastinal lymph node exhibited only medullary carcinoma components. At 11 months postoperatively, computed tomography scans showed enlargement of the right supraclavicular and upper mediastinal lymph nodes. FNA cytology of the right supraclavicular lymph node suggested the recurrence of medullary thyroid carcinoma. The gene panel testing (The Oncomine Dx Target Test Multi-CDx system®, Thermo Fisher SCIENTIFIC) of metastatic lymph node revealed RET somatic mutation (M918T). Treatment with selpercatinib was initiated, and both the cervical and mediastinal lymph nodes showed a reduction in size. CONCLUSIONS: We report a rare case of selpercatinib use for MMFCC. Since RET mutations may occur frequently in MMFCC, selpercatinib could be effective in treating MMFCC.
ABSTRACT
Giant cell tumor of bone (GCTB) consists of a mixture of neoplastic mononuclear cells and non-neoplastic cells, including polynuclear giant cells. Recently, with the spread of the immunohistochemical staining marker H3.3 G34W corresponding to specific genetic abnormalities, the histological diversity of GCTB has been recognized. GCTB without giant cells is uncommon, although it has also been reported previously. Herein, we describe a 45-year-old man with GCTB without giant cells who was successfully diagnosed using H3.3 G34W immunohistochemistry. Other unusual findings in GCTB that were identified in this patient include bone and osteoid formation with a long clinical course of 13 years. We also compared the histological findings of the current patient to those who received denosumab therapy.
Subject(s)
Bone Neoplasms , Giant Cell Tumor of Bone , Male , Humans , Middle Aged , Histones/genetics , Giant Cell Tumor of Bone/diagnosis , Giant Cell Tumor of Bone/genetics , Giant Cell Tumor of Bone/pathology , Bone Neoplasms/diagnosis , Bone Neoplasms/pathology , Giant Cells/pathology , Immunohistochemistry , Denosumab/therapeutic useABSTRACT
This study examined the stability and variability of interpersonal coordination, in which one person breathed while the other moved a wrist back and forth with an inverted pendulum in hand. Nine pairs of subjects coordinated each other's movement in two relative phase modes. In one mode, Radial flexion-Inspiration and Ulnar flexion-Expiration (RIUE), one subject radially flexed the wrist as the other inhaled and ulnarly flexed it as the other exhaled. In the other, Ulnar flexion-Inspiration and Radial flexion-Expiration (UIRE) mode, the wrist was ulnarly flexed at inhalation, and radially flexed at exhalation. Results were as follows: (1) The two were more highly coordinated in RIUE mode than UIRE mode as the frequency of oscillation increased. (2) Phase transitions were observed from URIE to RIUE mode, as the frequency of oscillation increased. And (3) the more different in preferred frequency the pendulum and breathing movements were, the more deviated from the intended relative phase the coordination became. These results suggest that interpersonal coordination of breathing and wrist-pendulum movement is qualitatively equivalent to intra personal coordination between them.
