SARS-CoV-2 detection in primary thyroid sarcoma: coincidence or interaction?

M. L. Tanda, S. Ippolito, D. Gallo, A. Baj, F. Novazzi, A. Genoni, M. Annoni, N. Mancini, N. Clementi, G. Finzi, E. Piantanida, P. Premoli, A. Lai, D. Dalla Gasperina, F. Maggi, S. Uccella

Research output: Contribution to journalArticlepeer-review


Introduction: Thyroid dysfunctions associated with SARS-CoV-2 are emerging in scientific literature. During the second COVID-19 epidemic spread, we evaluated a patient with the suspect of subacute thyroiditis. Methods and results: Specimen from fine-needle aspiration of a hypoechoic undefined area was analyzed for cytology and for SARS-CoV-2 detection. SARS-CoV-2 was retrieved by real-time polymerase chain reaction on the cytologic sample, which was then cultured on Vero E6 cells and demonstrated to be cytopathic. Whole-genome sequence was deposited. Histological exam diagnosed a rare case of primary thyroid sarcoma with diffuse and strong expression of mouse double minute 2 homolog (MDM2) oncoprotein. Ultrastructural examination confirmed, in several neoplastic cells, the presence of viral particles in cytoplasmic vacuoles. Conclusions: In our hypothesis, SARS-CoV-2 and sarcoma coexistence could represent a synergistic interplay, ultimately favoring both viral persistence and tumor proliferation: the overexpression of MDM2 in tumor cells might have generated a favorable immunological niche for SARS-CoV-2 localization and, in turn, SARS-CoV-2 could have favored tumor growth by inducing MDM2-mediated p53 downregulation. Functional studies are needed to confirm this suggestive pathway.

Original languageEnglish
Pages (from-to)1059-1063
Number of pages5
JournalJournal of Endocrinological Investigation
Issue number5
Publication statusPublished - May 2022


  • MDM2
  • Sarcoma
  • SARS-CoV-2
  • Subacute thyroiditis
  • Thyroid

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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