Spindle Epithelial Tumor with Thymus-Like Differentiation (SETTLE) in a Child, Diagnostic and Treatment Challenge: Case Report

Authors

  • Alexandre Andrade Sousa Sociedade Brasileira de Cirurgia de Cabeça e Pescoço. Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Departamento de Cirurgia. Belo Horizonte (MG), Brasil. https://orcid.org/0000-0002-4204-9334
  • Gabriela Somma Gomes Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina. Belo Horizonte (MG), Brasil. https://orcid.org/0000-0003-1193-0644
  • Matheus Eduardo Soares Pinhati Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina. Belo Horizonte (MG), Brasil. https://orcid.org/0000-0003-4718-8840
  • Alyrio Mourão Oliveira Valério Pesquisador autônomo. Belo Horizonte (MG), Brasil. https://orcid.org/0009-0009-3102-8878
  • Diogo Melgaço Faria Pesquisador autônomo. Belo Horizonte (MG), Brasil. https://orcid.org/0009-0003-1094-2034
  • Amanda de Moura Malta Carvalho da Mata Faculdade Ciências Médicas de Minas Gerais, Curso de Medicina. Belo Horizonte (MG), Brasil. https://orcid.org/0009-0001-3436-8685

DOI:

https://doi.org/10.32635/2176-9745.RBC.2025v71n2.5029

Keywords:

Thyroid Neoplasms/surgery, Thyroidectomy, Head and Neck Neoplasms/surgery, Case Reports, Child, Preschool

Abstract

Introduction: Spindle cell epithelial tumor with thymus-like differentiation (SETTLE) is an extremely rare and difficult-to-diagnose thyroid tumor that derives from ectopic thymic cells or branchial pouches. This thyroid tumor variant is usually found in children, adolescents, and young adults, and is rarely observed in elderly patients, in addition to having great potential for metastatic spread. The classic presentation is a painless and usually asymptomatic cervical mass in the topography of the thyroid. Its serum markers are nonspecific. Given the scarcity of data on this neoplasm and the importance of alerting to this diagnostic possibility, a case report was carried out on a patient diagnosed with SETTLE, focusing on the differential diagnosis and treatment of this tumor variant, aiming to add more information about this condition to the literature. Case report: A 2-year-old male child who presented with a potentially malignant thyroid tumor mass with immunohistochemical analysis indicative of SETTLE. The patient underwent imaging tests and fine needle aspiration biopsy, which helped in the decision for an initial surgical approach. Thyroidectomy was performed, followed by long-term oncological follow-up. Conclusion: SETTLE is a rare thyroid tumor with slow metastatic potential that affects mostly children and adolescents and is difficult to diagnose, requiring attention to differential diagnosis. The main diagnostic test is immunohistochemical analysis and the main treatment is surgery, followed by prolonged follow-up.

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References

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Published

2025-04-25

How to Cite

1.
Sousa AA, Gomes GS, Pinhati MES, Valério AMO, Faria DM, Mata A de MMC da. Spindle Epithelial Tumor with Thymus-Like Differentiation (SETTLE) in a Child, Diagnostic and Treatment Challenge: Case Report. Rev. Bras. Cancerol. [Internet]. 2025 Apr. 25 [cited 2025 Dec. 6];71(2):e-155029. Available from: https://rbc.inca.gov.br/index.php/revista/article/view/5029

Issue

Vol. 71 No. 2 (2025): Apr./May/June

Section

CASE REPORT

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