Spindle cell tumour with thymus‐like differentiation (SETTLE) on fine needle aspiration cytology: A case report highlighting diagnostic pitfalls. Issue 8 (1st April 2021)

• Record Type: Journal Article
• Authors: Adegun, Oluyori K.; Proctor, Ian; Falzon, Mary; Pomplun, Sabine
• Is Part Of: Diagnostic cytopathology. Volume 49:Issue 8(2021)
• Page Start: E325
• Page End: E328
• Publication Date: 2021-04-01
• Subjects: diagnostic pitfalls -- medullary thyroid carcinoma -- metastatic small round blue cell tumours -- neck mass -- SETTLE; Cytodiagnosis -- Periodicals; Pathology, Cellular -- Periodicals; Cytology -- Periodicals; 616.07582
• DOI: 10.1002/dc.24744
• Languages: English
• ISSNs: 8755-1039

Abstract

Abstract: A 7‐year‐old girl presented with a painless neck swelling localised near the left lobe of the thyroid gland, which was initially investigated by fine needle aspiration cytology. This raised a differential diagnosis of medullary thyroid carcinoma and small round blue cell tumour. Only after several additional clinical investigations and a total thyroidectomy was a definitive diagnosis of spindle cell tumour with thymus‐like differentiation (SETTLE) reached. This case report highlights how contemporaneous clinical and investigation findings made arriving at a definitive diagnosis challenging, contributed to diagnostic delay, and ultimately influenced choice of treatment.