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BACKGROUND: Macrofollicular variant of papillary thyroid carcinoma (PTC) is an uncommon, recently described thyroid tumor. By frozen section it can be confused easily with goiter or macrofollicular adenoma. CASE: A 41-year-old female presented with a huge mass in the right thyroid lobe, cold on scintigraphy. By fine needle aspiration fluid was obtained. Smears of the sediment of the fluid showed epithelial cells with morphologic features diagnostic of PTC. Frozen section diagnosis was benign. CONCLUSION: This is the first reported case of macro-follicular variant of PTC diagnosed preoperatively by cytology. In our case the cytology was similar to that of cystic PTC.

The impetus given to modern oncology by the development of estrogen (Er) and progesterone (Pr) receptor assays in primary breast cancers has resulted in considerable progress in our understanding of endocrine manipulation. However some 30 percent-40 percent of Er (+) Pr (+) patients fail to respond to endocrine therapy. This may be due to the heterogeneity of tumor cell populations, the role of other hormones in growth regulation, as well as possible defects in estrogen-progesterone action on breast cancer, and variation in the interpretation of assays and clinical problems in evaluation of the tumor response. This study summarizes Kuwait Cancer Control Center (K.C.C.C.) experience, and is a current summary of our ongoing study of Er/Pr receptor assessment correlated with histologic analysis of primary and metastatic cancer and their response to treatment.

Pretreatment serum concentrations of breast carcinoma antigen (CA 15.3) and mucin-like carcinoma-associated antigen (MCA) were determined in 129 patients with breast carcinoma. Concentrations of both markers were within the normal range in patients with Stage I disease. Concentrations of CA 15.3 were elevated (greater than 40 U/ml) in 3, 11 and 48%, those of MCA (greater than 17 U/ml) in 11, 18 and 52%, and those of one or the other marker in 11, 18 and 58% of the patients with Stage II, III and IV disease, respectively. The elevation of either marker roughly paralleled the size of the tumor being normal in the patients with localized cancer, slightly elevated in a small proportion of the patients with locoregional cancer, and moderately to markedly elevated in half of the patients with distant metastases. Correlation between serum concentrations of CA 15.3 and MCA was highly significant (p less than 0.0001). It is concluded that the markers were equally sensitive and that an elevated serum level was a useful adjunct for staging, implying systemic disease.