Primary thyroid-like low-grade nasopharyngeal papillary adenocarcinoma: A case report and literature review.
RATIONALE: Primary thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TL-LGNPPA) is an extremely rare malignant nasopharyngeal tumor with features resembling papillary thyroid carcinoma including nuclear positive expression of thyroid transcription factor-1 (TTF-1). PATIENT CONCERNS: A 64-year-old male presented with nasal bleeding and a foreign body sensation of the nasopharynx. Laryngoscopy revealed a 2.0-cm broad-based mass with a smooth surface on the posterior wall of the nasopharynx. A biopsy was obtained. DIAGNOSES: Histopathologic examination demonstrated tumor cells arranged in both papillary and glandular architecture. The tumor cells express nuclear immunoreactivity for TTF-1. The diagnosis of TL-LGNPPA was made. INTERVENTIONS: After the patient was diagnosed with TL-LGNPPA, he underwent complete surgical resection. OUTCOMES: There was no recurrence or evidence of metastatic disease at the 12-month follow-up. LESSONS: TL-LGNPPA is easy to misdiagnose as metastatic papillary thyroid carcinoma or other relative primary adenocarcinomas. It is important to have a broad differential diagnosis and know the key features of each entity because the prognosis and clinical treatment of each may differ.
Zhang, W-L; Ma, S; Havrilla, L; Cai, L; Yu, C-Q; Shen, S; Xu, H-T; Wang, L; Yu, J-H; Lin, X-Y; Wang, E; Yang, L-H
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