SCLEROSING MUCOEPIDERMOID CARCINOMA WITH EOSINOPHILIA OF THE THYROID - REPORT OF 2 PATIENTS, ONE WITH DISTANT METASTASIS, AND REVIEW OF THELITERATURE

Sclerosing mucoepidermoid carcinoma with eosinophilia (SMECE) is a rec ently recognized malignant neoplasm of the thyroid gland. Two addition al cases of this condition which occurred in a 70-year-old woman and a 69-year-old woman are presented. The case of the 70-year-old woman (p atient 1) is the first report of distant metastasis, besides lymph nod e metastasis, for this type of tumor. The patient initially presented with a thyroid mass, and the thyroid gland with surrounding cervical l ymph nodes was removed. Because of focal keratin ''pearl'' formation, the tumor was misinterpreted as a metastatic squamous cell carcinoma t o the thyroid. Approximately 4 years later, the patient developed a le ft supraclavicular mass and lung densities. A pathological fracture of the right humeral head followed, and the left supraclavicular mass re curred along with newly developed subcutaneous nodules on the chest wa ll and arm. Open lung and bone biopsies revealed metastatic SMECE, whi ch was morphologically identical to that of the thyroid mass. The 69-y ear-old woman (patient 2) had, in 1983, undergone thyroidectomy with l eft radical neck dissection; this had been diagnosed as follicular car cinoma of the thyroid with lymph node involvement. After multiple isol ated lymph nodes metastases, the patient developed locally extensive, recurrent tumor that showed microscopic features of SMECE. Review of t he previous thyroid tumor and lymph nodes revealed the same type of hi stology. To our knowledge, only a single report containing eight cases of this distinctive carcinoma of the thyroid has been published. Here in we describe characteristic morphological features of two additional cases of this rare malignancy, one with distant metastasis, and we re view the related literature. Copyright (C) 1997 by W.B. Saunders Compa ny.