Electron microscopic analysis of an angiosarcoma of the thyroid from a non-Alpine endemic goiter region: A case report and brief review of the literature

Angiomatoid tumors of the thyroid gland are rare endocrine neoplasms, which exhibit an aggressive behavior. Angiosarcomas of the thyroid are generally reported from the European Alpine region and have a histogenesis that has been under debate for a number of years. The current study presents a rare case of angiosarcoma of the thyroid in a 62-year-old Turkish female. The patient had a 10-year history of goiter and was from the Black Sea region, an endemic goiter region of Turkey. The patient was not taking any medication at the time of admission and swelling had been observed on the right side of the neck throughout the previous few months. Thyroid function tests, which analyzed the levels of thyroid-stimulating hormone, thyroxine and triiodothyronine, were within the normal limits, however, the histopathological findings were consistent with an angiosarcoma of the thyroid. The patient rejected the complementary surgery and chemotherapy options, and is currently disease-free (as per the 15-month follow-up). The current study describes a case of angiosarcoma that was characterized by Weibel-Palade bodies, and light microscopy and immunohistochemical findings, as well as an endothelial origin, which was demonstrated via electron microscopy. To the best of our knowledge, this is the first reported case of angiosarcoma of the thyroid in a patient from Turkey to be validated by electron microscopy. Furthermore, this case is one of the few reported thyroid angiosarcoma cases in a non-Alpine region.