Rare Metastases of Well-Differentiated Thyroid Cancers: A Systematic Review

Madani, Amin; Jozaghi, Yelda; Tabah, Roger; How, Jacques; Mitmaker, Elliot J.

doi:10.1245/s10434-014-4058-y

Cited by 52 publications

(65 citation statements)

References 20 publications

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“…In fact, metastatic PTCs account for <0.6% of all malignant pleural effusions. 9 The diagnosis of malignant pleural effusion due to thyroid primary is prognostically important as it is associated with decrease in median survival to as low as 10 months. 8 The reason is probably because most thyroid carcinomas are well differentiated papillary carcinomas which have a propensity for lymph node metastasis and distant metastases are relatively rare.…”

Section: Discussionmentioning

confidence: 99%

Metastatic thyroid carcinoma presenting as malignant pleural effusion: A cytologic review of 5 cases

Vyas

Harigopal

2016

Diagnostic Cytopathology

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Malignant pleural effusion can be a manifestation of many malignancies. Involvement of pleural fluid by metatstatic thyroid carcinoma, though reported, is relatively rare. We present 5 cases of metastatic thyroid carcinoma involving the pleural fluid. The diagnosis of thyroid carcinoma in pleural fluid can be particularly challenging as thyroid transcription factor -1 (TTF-1) which is a marker for carcinoma of thyroid origin is also positive in lung adenocarcinomas (which are more frequently associated with pleural effusions) and thyroglobulin (TG) can often be negative in poorly differentiated/analplastic thyroid carcinomas. In our experience, PAX8 is a particularly useful marker in making the distinction. The diagnosis of metastatic thyroid carcinoma in pleural fluid can be challenging and knowledge of the clinical context and supporting immunohistochemical stains is essential for making the right diagnosis. Diagn. Cytopathol. 2016;44:1085-1089. © 2016 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 99%

Metastatic thyroid carcinoma presenting as malignant pleural effusion: A cytologic review of 5 cases

Vyas

Harigopal

2016

Diagnostic Cytopathology

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“…Four of these were follicular and 2 were papillary carcinomas (13). As already stated above, by the year 2015, less than 25 cases had been published in medical literature (9,11).…”

Section: Discussionmentioning

confidence: 86%

“…However, the detection of these metastases during life is very rare (2,10). By the year 2015, less than 25 cases of renal metastases from thyroid cancer were reported in the English-language literature, with most of the subjects being female and over 45 years of age (5,9,11). Seven patients had conventional PTC, 6 had a follicular variant of PTC, and 11 had FTC (5).…”

Section: Introductionmentioning

confidence: 99%

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

Chen-Ku

Roldán

2016

AACE Clinical Case Reports

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Objective: The objective of this study is to report a very unusual case of papillary thyroid cancer with metastases to kidney and hematogenous spread to the pharynx.Methods: We reviewed all clinical data available for this patient, including computed tomography (CT) images and pathology samples. A literature search for kidney and pharynx metastases was performed in MEDLINE, using the terms "kidney metastases," "pharynx metastases," and "thyroid cancer." Relevant references were selected and reviewed.Results: A 50-year-old Hispanic woman with a history of papillary thyroid carcinoma (PTC), a total thyroidectomy, plus a modified radical neck dissection, who was treated on 2 separate occasions with 131 I (initially 100 mCi, and 1 year later 200 mCi), persisted with elevated thyroglobulin levels. An abdominal CT scan revealed a 3-cm lesion in the left kidney with no metastases to the lungs, bone, or liver. A left nephrectomy was performed. The pathology report confirmed metastases from PTC. Even then, thyroglobulin levels remained elevated. One year later, a CT scan was performed due to a chronic sinus infection, and it showed a mass in the right pharynx region. Fine-needle aspiration biopsy of this lesion reported metastases from PTC.Conclusion: PTC usually has a very indolent behavior. When metastasis is present it normally involves cervical nodes, lungs, or bone. In the medical literature, there are very few case reports of PTC metastases to kidney, such as in our case. To our knowledge, this is the first case report with kidney and pharynx involvement from a PTC. (AACE Clinical Case Rep. 2016;2:e86-e90) Abbreviations: CT = computed tomography; DTC = differentiated thyroid carcinoma; FTC = follicular thyroid carcinoma; NIS = sodium/iodide symporter; PTC = papillary thyroid carcinoma; Tg = thyroglobulin; TSH = thyrotropin

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“…However, a recent systematic review by Madani and coworkers (14) revealed that, among 492 patients with differentiated thyroid cancer and rare sites of end-organ distant metastases, the brain was the most commonly affected organ within the rare locations. In 1986, McConahey and coworkers (15) verified that 15% of the patients with metastatic papillary thyroid carcinoma developed CNS metastases along their disease course.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of a cohort of patients with central nervous system metastases from thyroid cancer

Simões‐Pereira¹,

Macedo²,

Bugalho³

2016

Endocrine Connections

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IntroductionMetastases to central nervous system (M1-CNS) are rarely reported in thyroid cancer (TC) patients. We aimed to characterize patients with M1-CNS from TC followed in our department.MethodsReview of the medical records of 27 patients with TC-related M1-CNS.ResultsMean age at TC diagnosis was 56.9 ± 19.1 years. Papillary TC (55.6%) was the commonest histological type, followed by poorly differentiated (18.5%), medullary (11.1%), follicular (7.4%) and Hürthle cell (7.4%) carcinomas. Angioinvasion and extrathyroidal extension were observed in a high number of patients. At M1-CNS diagnosis, other distant metastases were already present in 77.8% of the patients. Treatment directed to M1-CNS was offered to 20 (74%) patients: 1 was submitted to surgery, 18 to radiotherapy (either whole-brain radiotherapy or stereotaxic radiosurgery or both) and 4 to surgery and radiotherapy. Four patients received cytotoxic chemotherapy and one was submitted to 131I. Median survival since M1-CNS detection was 5.0 months. The only factor associated with better survival was surgery to brain metastases (P = 0.012).ConclusionsThe management of these patients is very challenging given the inexistence of effective treatments, except for brain surgery in selected cases.

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Rare Metastases of Well-Differentiated Thyroid Cancers: A Systematic Review

Abstract: WDTC can manifest with highly variable and unusual clinical features. Rare sites of metastases should be considered in the absence of the more common extra-cervical disease recurrence locations.

Cited by 52 publications

References 20 publications

Metastatic thyroid carcinoma presenting as malignant pleural effusion: A cytologic review of 5 cases

Metastatic thyroid carcinoma presenting as malignant pleural effusion: A cytologic review of 5 cases

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

Clinical outcomes of a cohort of patients with central nervous system metastases from thyroid cancer

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