Metastatic thyroid carcinoma masquerading as lacrimal gland tumor

Bernstein-Lipschitz, Liora; Lahav, Moshe; Chen, Varda; Gutman, Isaac; Gal, Rivka; Lipschitz, Meir

doi:10.1007/bf00935717

Cited by 7 publications

(1 citation statement)

References 7 publications

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“…Reviewing all previous papers, to our knowledge 23 cases of thyroid carcinomas with orbital metastases have previously been described (13)(14)(15)(16)19,21,(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53) (Table 1).…”

Section: Discussionmentioning

confidence: 99%

Orbital metastasis from thyroid cancer: a case report and review of the literature

Sapuppo¹,

Martorana²,

Tirr³

et al. 2022

Ann Palliat Med

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Background: Differentiated thyroid cancer (DTC) is generally associated with an excellent prognosis.However up to 20% of DTC patients have disease events during subsequent follow-up; rarely patients present an aggressive disease with distant metastases (DM), mainly in the lung and bone. Metastases at unusual sites may also occur, generally in patients with disseminated disease. Orbital localization is rare and only few cases have been described so far.Case Description: A 36 years-old man, treated with chemo and radiotherapy during childhood for non-Hodgkin lymphoma, was referred for suspicious lymph node (LN) and multiple lung metastases. Total thyroidectomy and latero-cervical (LC) lymphadenectomy were performed: papillary thyroid cancer (PTC), 25 mm, 11/17 LN metastases; pT2N1bM1. Post-treatment total body scan with I-131 showed LN and lung uptake. Eighteen months from diagnosis he presented progressive diplopia, proptosis and right exophthalmos due to an 18 mm orbital metastasis. Hence, due to I-131 refractoriness for structural disease progression despite I-131 therapy, he started therapy with Lenvatinib for 6 months, with initial partial response followed by disease progression, and then with Cabozantinib, which he stopped after 6 months for adverse events and disease progression after therapy reduction. Currently, the patient is receiving Lenvatinib, rechallenge therapy, with disease stabilization and biochemical response. Molecular analysis, performed on both primary and relapsed tumor didn't show any significant pathogenic alteration.Conclusions: This case of DTC with an unusual metastasis in the orbit, may suggest that patient's exposure to chemo-and radiotherapy during pediatric age might have played a role in the subsequent development of this unusually aggressive tumor, reinforcing the recommendation of long-term and intensive follow-up of these patients.

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Section: Discussionmentioning

confidence: 99%

Orbital metastasis from thyroid cancer: a case report and review of the literature

Sapuppo¹,

Martorana²,

Tirr³

et al. 2022

Ann Palliat Med

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Evaluation and Management of Metastatic Orbital Tumors

Valenzuela

McNab

2010

Oculoplastics and Orbit

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Lacrimal Gland Intravascular Micrometastasis From a Human Papillomavirus-Driven Anorectal Squamous Cell Carcinoma With a Review of Metastatic Disease to the Lacrimal Gland

Neerukonda

Freitag

Stagner

et al. 2020

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Purpose: To document a unique case of anorectal squamous cell carcinoma that was metastatic to the microvasculature of the lacrimal gland in a patient with human immunodeficiency virus and to review previously reported cases of metastases to the lacrimal gland. Methods: Both a retrospective chart review and comprehensive literature review were performed. The unusual histopathologic pattern of the current case was illustrated with immunohistochemical studies (CD31, D2-40, pancytokeratin, p16, and p63) and in situ hybridization studies for high-risk human papillomavirus types 16 and 18. Results: The authors describe the first case of metastatic anorectal squamous cell carcinoma to the lacrimal gland. Only 24 cases of metastatic disease to the lacrimal gland have been reported, the majority from breast carcinomas. The metastasis did not form a macroscopic lesions, instead was composed of microscopic intravascular and intraparenchymal tumor deposits, a subtle phenomena. Immunohistochemistry confirmed the presence of the intravascular neoplastic cells. p16 served as a surrogate marker for human papillomavirus-associated squamous cell carcinoma and was confirmed with in situ hybridization for human papillomavirus 16 and 18. This testing, combined with the clinical history, defined the diagnosis and confirmed human papillomavirus as the tumor driver. Conclusions: Metastases to the lacrimal gland remain rare, but clinicians and pathologists alike must be attuned to the possibility of subtle microscopic foci of tumor as a pattern of metastasis in scenarios without a discrete mass-forming lesion, as this may portend a poor prognosis.

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Metastatic thyroid carcinoma masquerading as lacrimal gland tumor

Cited by 7 publications

References 7 publications

Orbital metastasis from thyroid cancer: a case report and review of the literature

Orbital metastasis from thyroid cancer: a case report and review of the literature

Evaluation and Management of Metastatic Orbital Tumors

Lacrimal Gland Intravascular Micrometastasis From a Human Papillomavirus-Driven Anorectal Squamous Cell Carcinoma With a Review of Metastatic Disease to the Lacrimal Gland

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