Ectopic Thyroid Papillary Carcinoma with Cervical Lymph Node Metastasis as the Initial Presentation, Accompanied by Benign Thyroid Gland

Kola, Erisa; Musa, Juna; Guy, Ali; Kola, Ina; Horjeti, Edlira; Filaj, Vladimir; Alimehmeti, Mehdi

doi:10.5455/medarh.2021.75.154-157

Cited by 6 publications

(7 citation statements)

References 15 publications

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“…Our study in a female population showed that women with PTC who did have age, tumor diameter > 1, bilateral cancer, and extra-glandular invasion were more likely to have CLNM in univariate multivariate analysis for CLNM only. Some studies have shown that age, diameter, multifocality, and ETE are risk factors for CLNM [20][21][22], and although bilateral cancer is currently inconsistent in whether it is related to CLNM [20,23]. Our study was generally consistent with the previous overall study.…”

Section: Discussionsupporting

confidence: 90%

Risk of lymph nodes metastasis related to reproductive factors in PTC: Female gender

Wang,

Yang,

Feng

et al. 2023

Preprint

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Objective: Female reproductive factors have been associated with the development of papillary thyroid carcinoma (PTC), but their relationship with the progression is not clear.Therefore, this study focused on the relationship between female PTC progression and reproductive factors to improve individualized diagnosis and treatment options for female PTC. Methods:The clinicopathologic data of 1828 patients with PTC who were diagnosed in the Department of Western Campus of the Fourth Affiliated Hospital of Hebei Medical University from January 2015 to December 2019 were retrospectively analyzed. Results: Of 1828 women with PTC, 903 (49.4%) developed lymph node metastasis(LNM) during the first operation. Logistic regression analysis showed that the incidence of cervical lymph node metastasis (CLNM) was lower (OR = 0.414, 95% CI: 0.266 – 0.645) and the incidence of cervical and lateral lymph node metastasis (CLNM + LLNM) was also lower (OR = 0.346, 95% CI: 0.187 – 0.642) in those with reproductive history than in those without reproductive history. After propensity score matching was used to eliminate all potential positive confounders at baseline, the only outcome measure was LNM, and the results showed that the incidence of LNM was still lower in those with reproductive history than in those without reproductive history overall after excluding each confounding factor, and the difference was statistically significant (P = 0.049), and the positive rate in CLNM was mainly affected (P = 0.018). Conclusion: Female reproductive factors exert a significant influence on the occurrence of lymph node metastasis in PTC. For nulliparous women, as well as women > 55 years of age at menopause, early surgery is recommended if multifocal, bilateral, and extraglandular invasion is present, and ipsilateral central dissection is recommended actively, and if CLNM has been confirmed, lateral cervical lymph nodes are recommended to be vigilant and actively managed.

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Section: Discussionsupporting

confidence: 90%

Risk of lymph nodes metastasis related to reproductive factors in PTC: Female gender

Wang,

Yang,

Feng

et al. 2023

Preprint

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“…Since TSH controls both the gland volume increase and the thyroid hormones secretion/production, the ectopic tissue might become visible under these circumstances. Yet, the current level of understanding of TSH control over the ectopic tissue and the balance between thyroid hormone production within the follicular cells from eutopic and ectopic tissue is still low [31].…”

Section: The Issue Of Ectopic Thyroid Tissuementioning

confidence: 99%

Personalized Management of Malignant and Non-Malignant Ectopic Mediastinal Thyroid: A Proposed 10-Item Algorithm Approach

Carsote,

Ciobica,

Sima

et al. 2024

Cancers

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We aimed to analyze the management of the ectopic mediastinal thyroid (EMT) with respect to EMT-related cancer and non-malignant findings related to the pathological report, clinical presentation, imaging traits, endocrine profile, connective tissue to the cervical (eutopic) thyroid gland, biopsy or fine needle aspiration (FNA) results, surgical techniques and post-operatory outcome. This was a comprehensive review based on revising any type of freely PubMed-accessible English, full-length original papers including the keywords “ectopic thyroid” and “mediastinum” from inception until March 2024. We included 89 original articles that specified EMTs data. We classified them into four main groups: (I) studies/case series (n = 10; N = 36 EMT patients); (II) malignant EMTs (N = 22 subjects; except for one newborn with immature teratoma in the EMT, only adults were reported; mean age of 62.94 years; ranges: 34 to 90 years; female to male ratio of 0.9). Histological analysis in adults showed the following: papillary (N = 11/21); follicular variant of the papillary type (N = 2/21); Hürthle cell thyroid follicular malignancy (N = 1/21); poorly differentiated (N = 1/21); anaplastic (N = 2/21); medullary (N = 1/21); lymphoma (N = 2/21); and MALT (mucosa-associated lymphoid tissue) (N = 1/21); (III) benign EMTs with no thyroid anomalies (N = 37 subjects; mean age of 56.32 years; ranges: 30 to 80 years; female to male ratio of 1.8); (IV) benign EMTs with thyroid anomalies (N = 23; female to male ratio of 5.6; average age of 52.1 years). This panel involved clinical/subclinical hypothyroidism (iatrogenic, congenital, thyroiditis-induced, and transitory type upon EMT removal); thyrotoxicosis (including autonomous activity in EMTs that suppressed eutopic gland); autoimmune thyroiditis/Graves’s disease; nodules/multinodular goiter and cancer in eutopic thyroid or prior thyroidectomy (before EMT detection). We propose a 10-item algorithm that might help navigate through the EMT domain. To conclude, across this focused-sample analysis (to our knowledge, the largest of its kind) of EMTs, the EMT clinical index of suspicion remains low; a higher rate of cancer is reported than prior data (18.8%), incident imagery-based detection was found in 10–14% of the EMTs; surgery offered an overall good outcome. A wide range of imagery, biopsy/FNA and surgical procedures is part of an otherwise complex personalized management.

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“…In a similar case of a 30-year-old woman with a history of Hashimoto's thyroiditis, her CT scan showed suspicious malignant lymph nodes, which were further con rmed by histopathologic examination. She underwent total thyroidectomy with neck dissection, and no carcinoma was found in the thyroid even if the thyroid gland was carefully reviewed sectionally (15). Another case was a 24-year-old female patient who accidently found a right lateral neck mass measuring 2.0 x 2.0 cm.…”

Section: Case Reviewmentioning

confidence: 99%

“…First, treatment interventions, such as neck surgery and radiation, may cause lateral ectopic thyroid (40). Second, some benign thyroid diseases may increase the risk of thyroid ectopy, such as thyroid goiter(6), lymphocytic thyroiditis(41) or Hashimoto's thyroiditis (15,41), according to existing studies and cases. However, further clinical analysis is required to make the nal conclusion.…”

Section: Ectopy Assumptionsmentioning

confidence: 99%

Ectopic thyroid tissue in the lateral lymph nodes: A rare case and literature review

Zhang,

Zheng,

Wang

et al. 2023

Preprint

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Background Ectopic thyroid tissue in the lateral lymph nodes is a rare phenomenon that is difficult to differentiate from metastatic thyroid carcinoma, which poses a great challenge to clinical decisions and may cause unnecessary operations. Puncture eluate thyroglobulin (FNA-Tg) of fine-needle aspiration is usually significantly elevated in malignant samples, but false-positive results still exist. Case Presentation We report a patient with lymph node ectopy who was suspected to have metastatic papillary thyroid cancer (PTC) preoperatively due to an undefined thyroid nodule and a drastically upregulated FNA-Tg level in the enlarged lymph nodes. In this review, we discuss the embryonic development of ectopic thyroid tissue in the lateral lymph nodes and the application of FNA-Tg in the diagnosis of nodal metastasis. We also present the individual treatment based on FNA and ultrasound evaluation. Conclusion For patients who have isolated suspicious lateral nodes but lack direct evidence of thyroid malignancy, ectopic thyroid tissue should be considered.

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Ectopic Thyroid Papillary Carcinoma with Cervical Lymph Node Metastasis as the Initial Presentation, Accompanied by Benign Thyroid Gland

Cited by 6 publications

References 15 publications

Risk of lymph nodes metastasis related to reproductive factors in PTC: Female gender

Risk of lymph nodes metastasis related to reproductive factors in PTC: Female gender

Personalized Management of Malignant and Non-Malignant Ectopic Mediastinal Thyroid: A Proposed 10-Item Algorithm Approach

Ectopic thyroid tissue in the lateral lymph nodes: A rare case and literature review

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