Local Recurrence in the Neck and Survival After Thyroidectomy for Metastatic Renal Cell Carcinoma

Abstract

Although significant improvement of local disease control in patients with thyroid metastases of RCC has been achieved during the last decade, overall outcome continues to be poor for patients with locally invasive thyroid metastases.

A single thyroid nodule revealing early metastases from clear cell renal carcinoma: case report and review of literature

“…Clinical presentation of ITM is nonspecific and tumors are often unsuspected especially when metastases develop many years after the primary diagnosis. Recently it has been reported that in 67% of ITM, indication to thyroidectomy was for suspected primary thyroid malignancies or nodular goiter [6]. Also in our case, ITM was the first metastatic site during follow-up for RCC removed 1 years before and it was misinterpreted as a primary thyroid tumor.…”

“…This event develop more often in patients with tumor spread to adjacent structures, and thyroid metastases exceeding 3.5 cm [6]. The risk of cervical recurrence was not reduced by total vs subtotal thyroidectomies [6].…”

“…In cases of aggressive primary RCC and diffuse metastases, the prognosis is poor and thyroid surgery is only recommended with palliative intent with the aim of improving quality of life by preventing airway obstruction [16]. However, for those patients with an indolent primary lesion and disease confined to the thyroid gland without significant extra-thyroid extension, surgery with curative intent is possible and may offer good survival rates and long disease-free intervals [6], [17]. For this reason, an aggressive operative approach has been advocated by several authors, considering the minimal morbidity associated, and a median survival of approximately 5 years despite the 20% of thyroidectomies were performed without curative intents [10], [18].…”

“…This event develop more often in patients with tumor spread to adjacent structures, and thyroid metastases exceeding 3.5 cm [6]. The risk of cervical recurrence was not reduced by total vs subtotal thyroidectomies [6]. However, should keep in mind that, for more patients, the primary indication to the thyroidectomy was primitive thyroid cancer or nodular goiter in which total thyroidectomy was wide accepted like standard of care.…”

Outcome of Patients with Renal Cell Carcinoma and Multiple Glandular Metastases Treated with Targeted Agents

“…RCC metastases to the thyroid usually appear as metachronous lesions, often presenting several years after nephrectomy. Moreover, their association with other MGM sites, mainly the pancreas, has been retrospectively documented [13,14] . Parotid metastases of RCC are rare, with a review in 2008 identifying only 26 cases of RCC metastasizing to the parotid [15] .…”