TWO CASES OF THYROID COLLISION TUMORS WITH DIFFERENT DIFFERENTIATION PATHWAYS

Authors

  • O. Kovalyov Zaporizhzhia State Medical and Pharmaceutical University, Zaporizhzhia, Ukraine
  • S. Zavhorodniy Zaporizhzhia State Medical and Pharmaceutical University, Zaporizhzhia, Ukraine
  • O. Tolok YULIS Medical Oncology Center, Zaporizhzhia, Ukraine
  • A. Anenko YULIS Medical Oncology Center, Zaporizhzhia, Ukraine
  • M. Kubrak Zaporizhzhia State Medical and Pharmaceutical University, Zaporizhzhia, Ukraine
  • M. Danilyuk Zaporizhzhia State Medical and Pharmaceutical University, Zaporizhzhia, Ukraine
  • K. Kovalyov Zaporizhzhia State Medical and Pharmaceutical University, Zaporizhzhia, Ukraine

DOI:

https://doi.org/10.15407/exp-oncology.2025.04.498

Keywords:

thyroid collision tumor, papillary carcinoma, follicular carcinoma, synchronous neoplasms

Abstract

Collision tumors of the thyroid gland are rare and characterized by the coexistence of two distinct neoplasms with different histopathological origins within the same anatomical region. We report two cases of synchronous thyroid carcinomas demonstrating divergent differentiation pathways: papillary thyroid carcinoma (PTC) combined with follicular carcinoma in one case, and PTC combined with a poorly differentiated component in the other case. Both cases presented with a long-term history of multinodular goiter but displayed rapid recent growth. Surgical treatment with total thyroidectomy was performed in both cases. Histopathology confirmed dual tumor composition with sharp topographic demarcation, supporting the diagnosis of collision tumors. We discuss clinicopathological features, diagnostic challenges, and potential mechanisms underlying synchronous tumorigenesis. While the exact pathogenesis remains unclear, environmental and molecular factors may contribute to divergent malignant transformation within a susceptible thyroid gland. Awareness of this phenomenon is crucial for accurate diagnosis and management.

References

Bulte CA, Hoegler KM, Khachemoune A. Collision tumors: A review of their types, pathogenesis, and diagnostic challenges. Dermatol Ther. 2020;33(6):e14236. https://doi.org/10.1111/dth.14236

Bojoga A, Stănescu L, Badiu C. Collision tumors of the thyroid. A special clinical and pathological entity. Arch Clin Cases. 2021;8(4):84-90. https://doi.org/10.22551/2021.33.0804.10191

Lazureanu DC, Anderco D, Dema S, et al. Collision tumors of the colon and peritoneum: signet-ring cell carcinoma and granular cell tumor. Life (Basel). 2023;13(12):2263. https://doi.org/10.3390/life13122263

Lamberg BA, Reissel P, Stenman S, et al. Concurrent medullary and papillary thyroid carcinoma in the same thyroid lobe and in siblings. Acta Med Scand. 1981;209(5):421-424. https://doi.org/10.1111/j.0954-6820.1981.tb11620.x

Thomas V, George R. Collision tumors of the thyroid: review of literature and report of a case of papillary-Follicular collision tumor. Thyroid Res Pract. 2018:15(2)60-64. https://doi.org/10.4103/trp.trp_6_18

Abdullah AM, Qaradakhy AJ, Ali RM, et al. Thyroid collision tumors: a systematic review. Barw Med J. 2024;2(3):44- 56. https://doi.org/10.58742/bmj.v2i2.94

Feng JW, Ye J, Hu J, et al. Synchronous papillary thyroid carcinoma and follicular thyroid carcinoma: case report and review of literature. Int J Clin Exp Pathol. 2020;13(11):2767-2771.

Bytnar JA, Enewold L, Shriver CD, Zhu K. Incidence of papillary thyroid cancer: Comparison of the military and the general population by race and tumor stage/size. Cancer Epidemiol. 2024;89:102539. https://doi.org/10.1016/j. canep.2024.102539

Soror NN, Shah P, Hemrock L, Bennett R. Primary Squamous cell carcinoma of the thyroid: a case report and lit- erature review about a rare entity. Cureus. 2021;13(5):e14963. https://doi.org/10.7759/cureus.14963

Brandwein-Gensler M, Urken M, Wang B. Collision tumor of the thyroid: a case report of metastatic liposar- coma plus papillary thyroid carcinoma. Head Neck. 2004;26(7):637-641. https://doi.org/10.1002/hed.20024. PMID: 15229907.

Koufopoulos N, Zacharatou A, Gouloumis AR, et al. Metastatic thyroid osteosarcoma with concomitant multifo- cal papillary carcinoma presenting as a collision tumor. Cureus. 2021;13(6):e15425. https://doi.org/10.7759/cu- reus.15425

Rossi S, Fugazzola L, De Pasquale L, et al. Medullary and papillary carcinoma of the thyroid gland occurring as a collision tumour: report of three cases with molecular analysis and review of the literature. Endocr Relat Cancer. 2005;12(2):281-289. https://doi.org/10.1677/erc.1.00901

Thomas A, Mittal N, Rane SU, et al. Papillary and medullary thyroid carcinomas presenting as collision tumors: a case series of 21 cases at a tertiary care cancer center. Head Neck Pathol. 2021;15(4):1137-1146. https://doi. org/10.1007/s12105-021-01323-7

Pishdad R, Cespedes L, Boutin R, et al. Coexistence of two different thyroid malignancies: a collision phenomenon.

Cureus. 2020;12(4):e7539. https://doi.org/10.7759/cureus.7539

Ljungberg O, Ericsson UB, Bondeson L, Thorell J. A compound follicular-parafollicular cell carcinoma of the thyroid: a new tumor entity? Cancer. 1983;52(6):1053-1061. https://doi.org/10.1002/1097-0142(19830915)52:6<1053::aid- cncr2820520621>3.0.co;2-q

Jin L, Chen E, Dong S, et al. BRAF and TERT promoter mutations in the aggressiveness of papillary thyroid carci- noma: a study of 653 patients. Oncotarget. 2016;7(14):18346-18355. https://doi.org/10.18632/oncotarget.7811

Ryan N, Walkden G, Lazic D, Tierney P. Collision tumors of the thyroid: A case report and review of the literature.

Head Neck. 2015;37(10):E125-E129. https://doi.org/10.1002/hed.23936

Nabili V, Natarajan S, Hirschovitz S, et al. Collision tumor of thyroid: metastatic lung adenocarcinoma plus pap- illary thyroid carcinoma. Am J Otolaryngol. 2007;28(3):218-220. https://doi.org/ 10.1016/j.amjoto.2006.08.002

Sharif R, Ooi TC. Understanding exposomes and its relation with cancer risk in Malaysia based on epidemio- logical evidence: a narrative review. Genes Environ. 2024;46(1):5. https://doi.org/10.1186/s41021-024-00300-0

Leeman-Neill RJ, Brenner AV, Little MP, et al. RET/PTC and PAX8/PPARchromosomal rearrangements in post- Chernobyl thyroid cancer and their association with iodine-131 radiation dose and other characteristics. Cancer. 2013;119(10):1792-1799. https://doi.org/10.1002/cncr.27893

Gianì F, Masto R, Trovato MA, et al. Heavy metals in the environment and thyroid cancer. Cancers (Basel). 2021;13(16):4052. https://doi.org/10.3390/cancers13164052

Tang M, Luo W, Zhou Y, et al. Anoikis-related gene CDKN2A predicts prognosis and immune response and me- diates proliferation and migration in thyroid carcinoma. Transl Oncol. 2024;40:101873. https://doi.org/10.1016/j. tranon.2023.101873

Gharib H. Does iodine cause thyroid cancer? Acta Endocrinol (Buchar). 2018;14(4):525-526. https://doi.org/10.4183/ aeb.2018.525

Barbaro D, Tessarolo A, Simi U, et al. Thyroid disease prevalence in carabineers deployed in a war theater. Mil Med. 2008;173(11):1098-1103. https://doi.org/10.7205/milmed.173.11.1098

Le KT, Sawicki MP, Wang MB, et al. High prevalence of agent orange exposure among thyroid cancer patients in the national VA healthcare system. Endocr Pract. 2016;22(6):699-702. https://doi.org/10.4158/EP151108.OR

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Published

05.03.2026

How to Cite

Kovalyov, O., Zavhorodniy, S., Tolok, O., Anenko, A., Kubrak, M., Danilyuk, M., & Kovalyov, K. (2026). TWO CASES OF THYROID COLLISION TUMORS WITH DIFFERENT DIFFERENTIATION PATHWAYS. Experimental Oncology, 47(4), 498–505. https://doi.org/10.15407/exp-oncology.2025.04.498

Issue

Vol. 47 No. 4 (2025): Experimental Oncology

Section

Case report

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