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Extensive mucoepidermoid carcinoma-like differentiation in follicular carcinoma of the thyroid

1 Department of Pathology, AIIMS, Bhopal, Madhya Pradesh, India
2 Department of Pathology and Lab Medicine, AIIMS, Bhopal, Madhya Pradesh, India
3 Department of Pathology, AIIMS, Mangalagiri, Andhra Pradesh, India
4 Department of ENT, AIIMS, Bhopal, Madhya Pradesh, India

Correspondence Address:
Ashwani Tandon,
Department of Pathology and Lab Medicine, AIIMS, Bhopal, Madhya Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcrt.JCRT_1422_20

Mucoepidermoid carcinoma (MEC) is a rare malignant thyroid neoplasm. Cases of MEC with papillary, insular, and anaplastic thyroid carcinoma have been reported. Here, we present a case of follicular carcinoma with extensive MEC-like differentiation. A 62-year-old female presented with complaint of thyroid swelling for 10 years. Cytological features were suggestive of follicular neoplasm. Contrast-enhanced computed tomography showed metastasis to lung and vertebrae. Salivary glands and breasts were normal on examination and imaging. Subtotal thyroidectomy with bilateral neck dissection surgery was performed. The specimen was submitted for histopathological examination. Microscopy showed features of follicular carcinoma with capsular and vascular invasion along with an additional MEC-like morphology. Follicular carcinoma with extensive MEC-like differentiation is a rare observation. Since the tumor was sparing salivary glands and breasts, we considered it as mucoepidermoid differentiation over a collision tumor. However, immunohistochemistry and molecular analysis were the limitations.

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