Am J Otolaryngol Head Neck Surg | Volume 3, Issue 2 | Case Report | Open Access

Papillary Thyroid Carcinoma Hobnail Variant: A Report of Two Cases and Literature Review

Arrangoiz R^1*, Moran R², Corona L³, Boy J³, Cordera F¹, Caba D¹, Muñoz Juarez M¹, Moreno E¹ and Luque-de-Leon E¹

¹Department of Surgical Oncology, Sociedad Quirurgica S.C., American British Cowdray Medical Center, Mexico
²Department of Surgery, American British Cowdray Medical Center, Mexico
³Department of Pathology, American British Cowdray Medical Center, Mexico

^*Correspondance to: Arrangoiz R 

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Abstract

An uncommon subtype of Papillary Thyroid Carcinoma (PTC) called Hobnail variant of Papillary Thyroid Carcinoma (HPTC) has recently been described and is distinguished by an aggressive behavior and somewhat poor prognosis. More than 100 cases have been published. HPTC is histological categorized by a predominantly micro papillary growth pattern and hobnail appearance of cells due to the apically placed bulging nuclei. To determine the diagnosis of a HPTC at least 30% of cells in the tumor are needed to display a hobnail-micro papillary pattern, though minor hobnail-micro papillary features are of consequence and should be noted in a pathology report. Fine needle aspiration cytology of these tumors will show micropapillary structures, loss of polarity, discohesiveness, and hobnail cells with teardrop appearance and soap bubble-like pseudo-nuclear inclusions. All these findings provide evidence for a preoperative diagnosis of HPTC, which may help to render a decision regarding the appropriate management (thyroid lobectomy vs. total thyroidectomy). Compared to patients with classic PTC, patients with HPTC frequently have extrathyroidal extensions, exhibit nodal or distant metastasis, and respond poorly to radioiodine treatment, factors which influence increased deaths among this subgroup of patients with PTC. We present two cases of PTC with prominent hobnail features and we will be reviewing the clinical, histological, and molecular characteristics of this aggressive variant of PTC.

Keywords:

Thyroid cancer; Papillary thyroid cancer; Variants of papillary thyroid cancer; Hobnail variant of papillary thyroid cancer; Aggressive variants of papillary thyroid cancer

Citation:

Arrangoiz R, Moran R, Corona L, Boy J, Cordera F, Caba D, et al. Papillary Thyroid Carcinoma Hobnail Variant: A Report of Two Cases and Literature Review. Am J Otolaryngol Head Neck Surg. 2020;3(2):1087.