🔬 Cytology. When a tumor masquerades as an old enemy: an error that was avoided.
✅ A 75-year-old patient with a history of melanoma presented with complaints of difficulty swallowing. A large tumor mass was found in the neck area. Suspicion immediately fell on a melanoma metastasis. However, cytological examination of the aspirate revealed unusual cells — giant, with an eccentric nucleus and a dense, included mass in the cytoplasm. This gave them a “rhabdoid” appearance.
❗ Immunohistochemistry disproved melanoma: the cells were positive for CKAE1/AE3 and PAX8 — markers characteristic of anaplastic thyroid carcinoma (ATC). This rare but extremely aggressive cancer accounts for only 2% of all thyroid tumors but leads to half of all deaths from them. The prognosis is unfavorable — most patients die within months.
⚠ The story emphasizes: even with an oncological history, it is important not to miss another, possibly more aggressive tumor. In such cases, rapid cytology and accurate immunodiagnosis are crucial.
👉 Source: Diagnostic Cytopathology Eshraghi R, Barkan GA, Pambuccian SE. Rhabdoid cells in the fine needle aspirate of a neck mass in a patient with history of melanoma: Anaplastic thyroid carcinoma. Diagnostic Cytopathology. 2019;1–5.
