Divergent Metastatic Patterns Between Subtypes of Thyroid Carcinoma Results From the Nationwide Dutch Pathology Registry

Abstract

Background Metastatic disease is the main cause of cancer-related mortality in thyroid carcinoma (TC) patients. Clinical studies have suggested differences in metastatic patterns between the different subtypes of TC. This study systematically evaluates the metastatic patterns of different subtypes in TC patients. Methods A nationwide review of pathological records of all 650 patients diagnosed with a primary malignancy in the thyroid who underwent an autopsy between 1991 and 2010 was performed. Patients were selected from the Dutch pathology registry (PALGA). Results Metastatic disease was present in 228 (35.1%) patients and was found in 38.7%, 17.3%, 75.4%, and 47.8% of patients with follicular, papillary, anaplastic, and medullary types of TC, respectively (P < .0001). The majority of patients had more than 1 metastasis. The most common site of metastatic disease was the lung for papillary (79.7%), follicular (72.9%), and anaplastic (92.1%) carcinoma but not for medullary carcinoma (56.3%), P < .0001. Medullary carcinoma patients most frequently had metastases to the liver (81.3%). The combination of metastases also differed between subtypes. Conclusion There are major differences in metastatic patterns between different subtypes of TC. The patterns and frequencies identified in this autopsy study may reflect the underlying biology of metastatic thyroid cancer and have potential to influence future monitoring and treatment strategies depending on clinical correlations.

Recurrent Hurthle cell thyroid carcinoma does not preclude long-term survival: a case report and review of the literature

“…Although reports of patients experiencing more than three metastatic sites are scarce, Hugen et al . reported that over 60% of all patients with metastasized DTC have multiple metastases, corroborating our findings [ 19 ]. However, this was an autopsy study, and some of the included patients were not diagnosed with a thyroid malignancy during their lifetime, limiting the applicability of these results.…”

<p>Circ_0058124 Upregulates MAPK1 Expression to Promote Proliferation, Metastasis and Metabolic Abilities in Thyroid Cancer Through Sponging miR-940</p>

“…Thyroid cancer (TC) is a common thyroid malignant tumor, including papillary TC, follicular TC, anaplastic TC and medullary TC. 1 Papillary TC is a more common type of TC, which has a lower degree of malignancy and a better prognosis. 2 In recent years, the incidence of TC has increased significantly, which is related to the region, race and gender.…”

Progression and dormancy in metastatic thyroid cancer: concepts and clinical implications

“…Thus, it is slower typically for well-differentiated thyroid cancers and faster for poorly differentiated or anaplastic thyroid cancers. This high frequency of silent metastases is supported by the aforementioned autopsy series in which 15.6% of the 359 patients diagnosed with thyroid cancer incidentally at autopsy also had distant metastases [10]. Thus, in thyroid cancer, it seems likely that the majority of "recurrence" at distant sites represents growth of preexisting metastases occurring as early stage events that are biologically dormant (i.e.…”

“…This "seed and soil" relationship for cancer metastasis, where the location of metastatic progression has tissue specificity, was suggested more than a century ago by Paget [7][8][9]. In thyroid cancer, the specificity of location of metastases for the different thyroid cancer subtypes was affirmed in a recent 25 year autopsy study that included more than 650 cases from the Netherlands [10]. Additionally, primary cancers are now recognized to be comprised from a non-uniform heterogeneous group of cancer cells along with stromal and immune cells that can both constrain and promote progression depending on their cell type [11].…”