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4 1) Hales M, Resenau W, Okerlund MD, et al: Carcinoma of the thyroid with a mixed medul lary and follicular pattern: morphologic, im munohistochemical, and clinical laboratory studies. Cancer 50: , ) DeLellis RA, Lloyd RV, Heitz PU, et al: Pathology and Genetics of Tumours of Endo crine Organs. IARC Press, Lyon, 2004, p ) Kashima K, Yokoyama S, Inoue S, et al: Mixed medullary and follicular carcinoma of the thyroid: report of two cases with an im- 26
5 munohistochemical study. Acta Pathol Jpn 43: , ) Papotti M, Negro F, Carney JA, et al: Mixed medullary-follicular carcinoma of the thyroid. A morphological, immunohistochemical and in situ hybridization analysis of 11 cases. Vir chows Arch 430: , ) Ogawa H, Kino I, Arai T: Mixed medullary -follicular carcinoma of the thyroid. Immuno - histochemical and electron microscopic studies. Acta Pathol Jpn 39: 67-72, ) Mizukami Y, Michigishi T, Nonomura A, et al: Mixed medullary-follicular carcinoma of the thyroid occurring in familial form. His topathology 22: , ) Shimizu M, Hirokawa M, LiVolsi VA, et al: Combined "Mixed Medullary-Follicular" and "Papillary" Carcinoma of the Thyroid with Lymph Node Metastasis. Endocr Pathol 11: , ) Papotti M, Volante M, Komminoth P, et al: Thyroid carcinomas with mixed follicular and C-cell differentiation patterns. Semin Diagn Pathol 17: , ) Holm R, Sobrinho-Simoes M, Nesland JM, et al: Medullary thyroid carcinoma with thyrog lobulin immunoreactivity. Lab Invest 57: , 1987 A special entity? 15) Noel M, Delehaye MC, Segond N, et al: Study of calcitonin and thyroglobulin gene expression in human mixed follicular and medullary thy roid carcinoma. Thyroid 1: , ) Johnston D, Hatzis D, Sunday ME: Expression of v-ha-ras driven by the calcitonin/calcitonin gene-related peptide promoter: a novel trans genic murine model for medullary thyroid car cinoma. Oncogene 16: , ) Volante M, Papotti M, Roth J, et al: Mixed medullary follicular thyroid carcinoma. Molecular evidence for a dual origin of tumor components. Am J Pathol 155: , 1999 A CASE OF MIXED MEDULLARY AND FOLLICULAR CELL CARCINOMA Takahito SAIKI, Yasuo YASUOKA and Atsushi YOSHIDA Department of Surgery, Saiseikai Matsuyama Hospital A 56-year-old woman was seen at the hospital for close exploration of a thyroid tumor which was detected at a medical checkup. Ultrasonographic study showed a hypo-echoic and ill-defined solid tumor, with the diameter of about 10mm, irregular margin, and heterogeneous inner part, in the inferior pole of the right lobe of thyroid. Thyroid carcinoma was diagnosed after close examinations, and a subtotal thyroidectomy with lymph node dissection was performed. Histopathological studies revealed that follicular structures of a large variety of sizes involving colloid were concomitantly present with medullary carcinoma showing a solid growth accompanied with amyloid deposits in the stroma. Immuno histochemical studies resulted in both calcitonin and thyroglobulin positive, and accordingly, mixed medullary and follicular cell carcinoma was diagnosed. Mixed medullary and follicular cell carcinoma of the thyroid is a rare thyroid tumor and 10 cases of the disease have been reported in this country. We present our case with a review of the literature.
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