Abstract
Two cases of papillary thyroid carcinoma (PTC), tall cell variant (TCV), are reported. A 66-year-old man and a 78-year-old man both presented with large swellings of their cervical lymph nodes, and subsequently underwent a total thyroidectomy and bilateral neck dissection. The histopathological findings revealed the presence of > 50% of tall tumor cells in the PTC. One year after the operation, the 66-year-old patient was found to have recurrences in the brain, cervix and axilla. Despite three series of γ-knife irradiation, he died of general metastases two years later. The 78-year-old patient is now preparing to undergo radioactive iodine therapy.
TCV is the most common (5-10%) of the seven subsets of PTC classified according to the 6th edition of the General Rules for the Description of Thyroid Cancer in Japan. The variant has a more aggressive behavior with higher recurrence and death rates than other PTCs. The histopathological findings of TCV show the characteristic nuclear features of PTC including an eosinophilic cytoplasm, with the height of > 50% of the tumor cells being at least twice their width. It has been reported that TCV tends to occur in patients older than 50 years and that the size of the initial tumor is larger than that of classical PTCs. TCV also shows aggressive characteristics such as nodal metastases and extrathyroid extensions, with a poorer prognosis than PTC.
Based on a thorough search of the Japanese literature we are only aware of 16 other reported cases of TCV.
