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Correspondence
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Volume 359:1295-1297 September 18, 2008 Number 12
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Diagnosis of Poorly Differentiated Thyroid Cancer with Radioiodine Scanning after Thyrotropin Alfa Stimulation

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To the Editor: Poorly differentiated thyroid cancers are rare and can be difficult for surgeons, endocrinologists, and pathologists to identify.1 These cancers fall into two main histologic categories: insular and other (large cell). Most, but not all, stain with thyroglobulin or thyroid transcription factor 1; those that do not represent particular diagnostic challenges.1,2,3 We describe a 60-year-old man who presented with bilateral cervical lymphadenopathy and an enlarged thyroid. Biopsy specimens of cervical nodes and the thyroid gland showed features of poorly differentiated adenocarcinoma of unknown primary origin — possibly pulmonary, colorectal, pancreatic, or thyroidal. Immunostaining for thyroglobulin and thyroid transcription . . . [Full Text of this Article]


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N Engl J Med 2008; 359:1738-1739, Oct 16, 2008; published at www.nejm.org on Sep 19, 2008 (10.1056/NEJMc0807896). Correspondence

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