Unusual Presentation of Differentiated Thyroid Cancer Metastasis

Abstract

Introduction The rates of thyroid cancers are on a rise, especially well-differentiated thyroid cancers. This could be partly due to newer diagnostic modalities, like high-resolution ultrasound, that can pick up smaller lesions. Differentiated thyroid cancers with distant metastases are not common, and even rarer is the initial presentation with complaints not related to the neck. Objectives The objective of this series was to study and report the unusual cases of patients with differentiated thyroid cancer with distant metastasis. There is a lack of data in the literature on these cases, and due to the rarity of such metastases, no definite treatment protocol has been defined. Methods A retrospective chart review of 1,200 cases of thyroid surgeries was performed. A total of 10 cases of well-differentiated thyroid cancer on the final histopathology exam that had initially presented with usual complaints to departments other than the Otolaryngology Department were identified. Results A total of 6 patients had papillary carcinoma, whereas 4 patients had follicular carcinoma on final the histopathology exam. Two patients presented with iliac crest lesions, 2 with vertebral lesions one each with parapharyngeal mass, supraclavicular mass, labia majora swelling and bleeding, lung, rib and neck of femur lesion. Conclusion There are still no specific guidelines on how to address these patients with differentiated thyroid cancer with distant metastasis (except for the cases of bone and lung lesions) and on which treatment should be offered in case of recurrence. More studies on the subject are required.

Differentiated Thyroid Carcinoma: Distant Metastasis as an Unusual Sole Initial Manifestation

“…The prevalence of distant metastasis in WDTC was reported up to 2.2% in a comprehensive Surveillance, Epidemiology, and End Results (SEER) database study ( 13 ). The most common sites of distant metastasis are the bones and the lungs, although involvement of other organs is also reported in the data, at a rate less than 5% ( 4 , 8 , 12 ). In our series, eight (80%) patients had osseous metastasis, one (10%) had pulmonary and one (10%) had combination of pulmonary and osseous metastasis, these findings are similar to the data reported in the literature ( 2 , 8 ).…”

“…Most of the times, thyroid carcinoma metastases remain asymptomatic and are only discovered on surveillance or whole-body metastatic work up ( 2 ). However, symptomatic distant metastasis can rarely present as an unusual and sole initial presentation of WDTC without any swelling in the neck ( 2 , 8 ).…”

Long noncoding RNA LINC00460 promotes carcinogenesis via sponging miR‐613 in papillary thyroid carcinoma

“…Most PTCs are effectively treated by surgical removal, followed by adjuvant radioactive iodine therapy, and the 5‐year survival rate is about 90%. However, some patients have a high degree of invasion with the development trend of dedifferentiation, which lead to poor prognosis (Iftikhar, Ikram, Muhammad, & Nathani, ). Therefore, it is urgently need to understand the molecular mechanism involved in PTC tumorigenesis and metastasis for further improving the cure rate and survival rate of patients.…”

Complete diaphysis resorption of the femur: A case report in a metastatic papillary thyroid cancer

“…Unusual manifestations of differentiated thyroid carcinoma have been reported as labia majora swelling, femur neck lesion, iliac crest swelling, as well as skin and pancreatic lesions as summarized by Iftikhar et al [ 15 ]. Brain and skull metastases are also rarely reported from well-differentiated thyroid cancer and are often associated with worse prognosis [ 16 ].…”