AI Article Synopsis
- CASTLE (Carcinoma showing thymus-like elements) is a rare tumor primarily affecting the thyroid, thought to arise from branchial pouch remnants or ectopic thymic tissue, and is typically treated with surgery and possibly radiotherapy.
- A 55-year-old woman was diagnosed with CASTLE after surgery for a parotid mass, confirmed by immunohistochemistry, and received postoperative radiotherapy.
- Genetic analysis revealed mutations in specific genes (PPARG, BRCA2, NOTCH1), and the patient remained disease-free for over a year, highlighting the need for clinicians to consider CASTLE in parotid gland cases.
Article Abstract
Background: Carcinoma showing thymus-like elements (CASTLE) is a rare tumor that normally affects the thyroid gland and was thought to arise from either the remnants of the branchial pouch or the ectopic cervical thymic tissue. These tumors show strong immunopositivity for CD5, P63, and CD117. Most CASTLE of the thyroid gland is treated with surgery with or without adjuvant radiotherapy or chemotherapy.
Method: A 55-year-old woman presented with a slow-growing right parotid mass. A right total parotidectomy and ipsilateral selective neck dissection were performed and the diagnosis of CASTLE was made after confirmation with an immunohistochemistry test. She received radiotherapy postoperatively.
Results: Genetic sequencing showed alterations in the PPARG, BRCA2, and NOTCH1 genes. She remained disease free for >1 year after treatment.
Conclusion: We believe that this is the first reported case of CASTLE in the parotid gland. Clinicians should be aware of this rare entity and consider this differential diagnosis after ruling out other common parotid lesions.
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| http://dx.doi.org/10.1002/hed.24985 | DOI Listing |
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