UNRAVELING THE JOURNEY TO INSULA - A RARE CASE REPORT OF THE INSULAR CARCINOMA OF THYROID

Insular carcinoma of the thyroid is considered to be a rare and very aggressive form of cancer in which the thyroid tissue undergoes neoplasm. It falls under the category of poorly differentiated carcinomas. As it was first characterized in the 1980s, it is regarded as an intermediate form of evolution between well-differentiated thyroid tumors (such as papillary and follicular carcinoma) and anaplastic thyroid carcinoma. It has some distinctive neurosurgical pathologic features such as nests or insulae composed of homogenous, uniform cells that can range from small to medium sized, exhibit vigorous cell division (mitosis), and necrosis. Relatively, insular carcinoma appears to middle aged and older patients who more often present with a neck mass that steadily increases in size over time while also showing signs of either local or remote metastasis. Because these tumors are aggressively progressive, they have worse prognosis than well differentiated forms of insular thyroid carcinomas, including increased recurrence rates and metastasis to lung or bone structures notably osteopetrosis. Diagnosis comes through histology slides with pathological microscopy imaging analysis combined with immune-microscopy techniques targeting specific antibodies directed against tumor markers. Treatment typically entails total gland excision followed by I131 radioactive iodine therapy with External Beam Radiation Therapy or Chemotherapy.