Laparoscopic partial nephrectomy of thyroid cancer metastasis: case report and review of the literature

Abstract

BackgroundFollicular cell thyroid carcinoma is a quite aggressive form of thyroid cancer. About 10% of follicular thyroid carcinoma shows multiple metastases: lung and bone are the most common sites of metastasis. Renal involvement from thyroid primary cancer is very rare with incidence of 4.5%–5.9%.PurposeWe report the first laparoscopic conservative treatment of renal metastasis from thyroid cancer. This is a new and useful approach in order to delay malignant disease progression and to reduce the surgical discomfort of the patient.Patients and methodsWe present the case of a 67-year-old woman, undergoing total thyroidectomy for follicular thyroid cancer with bone and lung metastasis. During adjuvant radiometabolic treatment, renal metastasis was diagnosed. Renal metastasis showed high metabolic activity, reducing the effectiveness of radioiodine therapy for secondary lesions. For this reason, we performed a laparoscopic simple enucleation of the single renal metastasis using extraperitoneal access and a clampless procedure.ResultsThe excision of the renal lesion improved the effectiveness of adjuvant radioiodine therapy: two months after surgery, the patient underwent adjuvant radiometabolic treatment with iodine-131 (150 mCi) and the following whole body scan showed only a small uptaking area at the level of the vertebral metastasis. The lung micrometastases were not detectable. At 36 months follow-up, malignant disease was clinically stable and well controlled.ConclusionMinimally invasive renal surgery with preservation of renal function and rapid recovery contributed to the success of radioiodine therapy and delayed the progression of the disease.

Unusual Papillary Thyroid Cancer Metastases to Kidney and Pharynx: A Case Report

“…Renal involvement from primary thyroid cancer is very unusual, with a prevalence of less than 6% in autopsy series (2,8), with an extremely rare detection during life (2,10), and until the year 2002, only 6 cases of metastatic renal tumor of thyroid carcinoma had been published in medical literature. Four of these were follicular and 2 were papillary carcinomas (13).…”

“…On the other hand, FTC is slightly more aggressive and represents a distinct histologic and clinical entity of DTC because of its propensity for vascular invasion and hematogenous spread. Metastases are mainly limited to regional lymph nodes, but 10 to 15% of patients with FTC will present with distant metastatic disease, usually in the lungs and bone (2,8).…”

“…Renal involvement from primary thyroid cancer is very unusual, with a prevalence of less than 6% (2,8,9) in autopsy series (10). However, the detection of these metastases during life is very rare (2,10).…”

Follicular Thyroid Carcinoma Metastatic to the Kidney: Report of a Case with Cytohistologic Correlation

“…FTC is considered a more aggressive tumor than PTC as it often presents at a higher stage, with distant metastases in 25 to 30% of cases [ 2 , 7 ]. Unlike PTC, which tends to metastasize to cervical lymph nodes, FTC more commonly presents with hematogenous metastases to lung and bone [ 2 , 7 , 8 ]; however, other metastatic sites have been reported as well. We report a case of FTC metastatic to the kidney in a patient presenting with a left renal mass, which was diagnosed by touch imprint cytology and histologic sections of a CT-guided renal core biopsy.…”

FDG PET/CT in the Detection of Pancreatic Metastasis in a Patient with Follicular Thyroid Carcinoma and Negative I-131 Whole Body Scan Findings

“…Metastatic FTC significantly contributes to disease morbidity and has been found to be associated with a 10-year survival of 40-45% (2). Therefore, among patients with well-differentiated thyroid carcinoma (DTC), metastatic disease and a more aggressive clinical course are often observed in those with FTC due to the propensity for vascular invasion and hematogenous spread (4). The hematogenous route is most often involved, either by way of the systemic circulation or occasionally via the paravertebral plexus.…”