Encapsulated Insular Carcinoma of Thyroid Gland

M. Bel Haj Salah, W. Koubaa, M. Ben Amor, O. Khayat, R. Jouini, E. BenBrahim, A. Chadly-Debbiche


To discuss clinical and pathologic features of this uncommon tumor with a review of literature.
We report the case of an encapsulated PD carcinoma of solid and trabecular pattern in a 50-years-old woman.
A thyroid lobectomy was performed on a left thyroid nodule with a deferred response on frozen section examination. The microscopic findings showed that the tumor was totally encapsulated without capsular invasion. It was characterized by well-defined solid nests (insulae), which were composed of rather small and uniform tumor cells with round to oval nuclei. Formation of small and colloid-containing follicles was associated with these nests to varying degrees.Immunohistochemical study showed positive stain for TTF1 and Thyroglobulin and a negative one for Calcitonin and neuroendocrine markers with a high Ki-67 index.
PD carcinoma generally occur in an older group than the well-differentiated tumors and are usually grossly invasive. Total encapsulation is even extremely rare event with only a few cases reported in the literature.

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