Diagnosis and Treatment of Metastases to the Thyroid Gland: a Meta-Analysis

Abstract

The thyroid is a rare site of clinically detectable tumor metastases; even though the gland is a highly vascularized structure, the frequency of metastases in the routine practice is less than 0.2% of all thyroid malignancies. The purpose of our meta-analysis is to evaluate the frequency of metastatic diffusion from other primary tumors to the thyroid gland and to suggest the best possible treatment through an evidence-based study. Relevant studies were identified by searching the following databases: PubMed, Scopus, and Web of Science. We selected all English-written articles published from 1995 to 2015. Studies were considered eligible if they reported the timing of metastatic spread and the site of the primary tumor in respect to the diaphragmatic region. Case reports were not included. Twenty-eight studies accounted for 514 patients. The rate of metachronous metastases was 69%. Fifty-three percent of primaries originated from the infradiaphragmatic region. Fine needle aspiration biopsy (FNAB) was done in 154 patients and 195 patients were treated mostly with surgery. A prevalence of primary tumors from the infradiaphragmatic region and of metachronous metastases was observed. Knowledge of the clinical history and the ancillary techniques can improve the sensitivity and accuracy of FNAB. Thyroidectomy may be considered a more effective treatment than radio-chemotherapy.

Thyroid Gland as a Target of Secondary Malignancies - an Autopsy Study and Review Data

“…Patients with secondary carcinoma of the thyroid from a lung primary have a particularly poor prognosis with most patients dying within months of metastatic disease. [27][28][29]58,59…”

Ultrasound‐guided FNA cytology of groin lymph nodes improves the management of squamous cell carcinoma of the vulva: Results from a comparative cytohistological study

“…According to the literature, it represents the first and most useful diagnostic tool in the evaluation of several body lesions. In fact, among the others, it has demonstrated interesting results in terms of diagnostic accuracy in head and neck cancer, breast carcinoma, and cervical carcinoma . To date, only 2 studies, from the same institution, have been published on the diagnostic utility of ultrasound with guided FNAC in the assessment metastatic lymph node disease in vulvar carcinoma.…”

“…In fact, among the others, it has demonstrated interesting results in terms of diagnostic accuracy in head and neck cancer, breast carcinoma, and cervical carcinoma. [10][11][12][13][14] To date, only 2 studies, from the same institution, have been published on the diagnostic utility of ultrasound with guided FNAC in the assessment metastatic lymph node disease in vulvar carcinoma. Moskovic et al, in their pilot study on 21 patients with early vulvar carcinoma using ultrasound and FNAC, confirmed an overall sensitivity of 83% and specificity of 82% for the detection of groin lymph node metastases.…”

“…It makes sense that a reliable tool in the evaluation of lymph nodes is represented by ultrasound combined with fine‐needle aspiration cytology (FNAC). This technique has demonstrated interesting results in terms of diagnostic accuracy in head and neck cancer, thyroid neoplasms, and breast, lung, and cervical carcinoma …”

“…This technique has demonstrated interesting results in terms of diagnostic accuracy in head and neck cancer, thyroid neoplasms, and breast, lung, and cervical carcinoma. [10][11][12][13][14] So far, only a few studies have investigated the diagnostic utility of ultrasound-guided FNAC of lymph nodes in the assessment of vulvar carcinoma, and the majority of them have had a prevalent focus on the radiological more than the cytological aspects of this examination. 15,16 In the current report, we evaluate the diagnostic accuracy of ultrasound-guided FNAC in our cohort of patients affected by vulvar carcinoma by comparing the reliability of cytological versus histological samples.…”