Recurrence of carcinoma showing thymus-like differentiation (CASTLE) involving the thyroid gland

Background Carcinoma showing thymus-like differentiation (CASTLE) in the thyroid gland is a rare disease with generally a favorable prognosis. Treatment with surgery and adjuvant radiotherapy has been shown to improve local control and long-term survival rates. In this report, we present a case of a...

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Published inThyroid research Vol. 14; no. 1; pp. 1 - 20
Main Authors Dang, N. V, Son, L. X, Hong, N. T. T, Nhung, N. T. T, Tung, N. T, Quang, L. V
Format Journal Article
LanguageEnglish
Published London BioMed Central Ltd 16.08.2021
BioMed Central
BMC
Subjects
Care and treatment
Case Report
CASTLE
CD5 antigen
Cellular biology
Development and progression
Dissection
Health aspects
Immunohistochemistry
Lymphatic system
Medical imaging
Medical prognosis
Metabolism
Metastasis
Ostomy
Pathology
Patients
Prognosis
Radiation therapy
Radiotherapy
Rare diseases
Surgery
Thymus
Thymus gland
Thyroid
Thyroid cancer
Thyroid gland
Thyroidectomy
Thyroxine
Tumors
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Summary:Background Carcinoma showing thymus-like differentiation (CASTLE) in the thyroid gland is a rare disease with generally a favorable prognosis. Treatment with surgery and adjuvant radiotherapy has been shown to improve local control and long-term survival rates. In this report, we present a case of a recurrent thyroid gland CASTLE and review the literature on the diagnosis and treatment of this disease. Case presentation A 60-year-old woman, who was diagnosed with a CASTLE thyroid tumor in 2015, had a total thyroidectomy and was maintained on thyroid hormone replacement (levothyroxine). After 5 years, the patient had a recurrence, in an advanced stage unsuitable for surgery. As the patient declined to undergo radiotherapy, she was followed up without intervention and is currently stable after 15 months. Conclusions CASTLE is a rare disease, diagnosed based on postoperative pathology and immunohistochemistry analysis, especially upon CD5 marker. In case of relapse, treatment options include surgery and radiotherapy; however conservative management without intervention is an acceptable alternative in some cases. Keywords: Thyroid cancer, CASTLE, Surgery, Radiotherapy
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ISSN:1756-6614
1756-6614
DOI:10.1186/s13044-021-00111-3