Angiosarcoma of the Thyroid and Regional Lymph Node Metastasis

Abstract

ÖzetTiroid anjiosarkomları tipik olarak infiltratif ve büyük tümörlerdir ve klinik bulguları anaplastik tiroid kanserine çok benzer. Erken hematojen yayılım çok sık iken, bölgesel lenf nodu metastazı oldukça nadirdir. Bu yazıda 68 yaşında bir erkek hastada bölgesel lenf bezi metastazı olan tiroid anjiosarkom olgusu bildirilmiştir. Hastaya total tiroidektomi ile birlikte sağ modifiye radikal boyun diseksiyonu uygulandı. Disseke edilen 19 lenf nodunun dördünde metastaz saptandı. Metastatik tümör çok sayıda kan dolu yarıkları içeren sarkomatöz alanlardan oluşmaktaydı. Ameliyattan sonra PET-CT çekilen hastada multipl metastazlar saptandı. Tiroid anjiosarkomları anjiomatoid anaplastik karsinomlardan tamamen farklı tümörler-dir. Bu tümörlerde uzun sağ kalım sadece agresif cerrahi ile mümkündür ve bölge-sel lenf bezi metastazı varlığında boyun diseksiyonu yapılmalıdır. Anahtar KelimelerTiroid; Anjiosarkom; Metastaz Abstract Thyroid angiosarcomas are typically infiltrative and large tumors with very similar clinical findings of anaplastic carcinoma of thyroid. Early hematogenous metastasis is very frequent, but regional lymph node metastasis is quite rare. We present a case of angiosarcoma of the thyroid gland in a 68 years old man with regional lymph node metastasis. Total thyroidectomy with right modified radical neck dissection was applied. Four out of 19 lymph nodes dissected were seen to contain metastasis. Metastatic tumor was composed of sarcomatous areas containing large numbers of blood filled clefts. There after the surgery PET-CT was performed and multiple metastatic involvements were reported. Thyroid angiosarcomas are completely different tumors from angiomatoid anaplastic carcinomas. Longer survival with these tumors is only possible with agressive surgery and in case of regional LN metastasis, neck dissection should be done.

An extremely rare case of thyroid malignancy from the non-Alpine region: Angiosarcoma

“…Although the incidence of thyroid angiosarcoma is high in the Alpine regions, such as in Switzlerand and Northern Italy, it is very low in rest of the world. There are only a few case reports from Turkey [6] . This tumor is predominantly reported in elderly patients with a history of nodular goiter for many years.…”

Metastatic Angiosarcoma of the Thyroid Gland: A Case Report

“…Chronic goiter is an important predisposing risk factor for angiosarcoma. Lymphedema and radition are the risk factors for sarcomas additionally hemorrhage into a adenoma is thought to be a predisposing factor for thyroid angiosarcoma (8,9). In a study, previous epithelial thyroid cancer was preexisted to thyroid angiosarcoma (10).…”

“…Thyroid angiosarcoma is seen predominantly in elderly patients with a history of goiter and especially in iodine deficient areas, similar to our case. A few case reported from Turkey (9,11).…”