Solitary skin metastasis as the presenting feature of differentiated thyroid microcarcinoma: Report of two cases

Abstract

Cutaneous metastases from thyroid neoplasia are very rare. Most patients presenting with such a disease have also both internal metastases and a very enlarged thyroid gland. We reported here 2 patients presenting with differentiated thyroid microcarcinoma which was revealed by a solitary scalp lesion. The positive immunoperoxidase staining for thyroglobulin (TG) in the skin tumour cells asserted the diagnosis of metastatic thyroid carcinoma. The thyroid neoplastic micronodular formation was unrecognized by ultrasonography and it was only found at serial histological examination of the thyroid gland entirely removed during surgery. Histological procedure showed a solitary follicular microcarcinoma (diameter = 0.5 cm) in 1 patient, and two differentiated microcarcinoma, a follicular microcarcinoma (diameter = 0.4 cm) in a lobe and a follicular-papillary carcinoma (diameter = 0.5 cm) in the other lobe, in the second patient.

Scalp metastases from thyroid carcinomas: review of clinical and pathological features

“…[16][17][18][19] Eighteen cases of FTC metastasis to scalp were reported in the literature [3,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] (Table 1). Two cases reported by Lissak et al [20] were follicular microcarcinoma revealed by solitary scalp lesions. The thyroid lesions of 0.4 and 0.5 cm size in the cases were unrecognized by ultrasonography and they were only detected at serial histological examination of thyroid glands removed during surgery.…”

“…The presenting symptom was a scalp lesion in 7 cases. [3,17,[20][21][22] Metastases to scalp 1 to 18 years after the diagnosis of the primary FTC were reported in the literature (Table 1).…”

An unusual case of papillary carcinoma of the thyroid with cutaneous and breast metastases only

“…Cutaneous metastases of these types of carcinomas are rarely seen, except in the vicinity of a locally invasive tumor. Skin metastases confirmed by immunohistochemistry have been reported in seven cases of follicular carcinoma (1)(2)(3)(4)(5) and in six cases of papillary carcinoma (5)(6)(7)(8), two of which were of the follicular variant type (5,6). Metastases from follicular carcinomas were located in the scalp (1,(3)(4)(5), neck (1) and cheek (2).…”

“…Skin metastases confirmed by immunohistochemistry have been reported in seven cases of follicular carcinoma (1)(2)(3)(4)(5) and in six cases of papillary carcinoma (5)(6)(7)(8), two of which were of the follicular variant type (5,6). Metastases from follicular carcinomas were located in the scalp (1,(3)(4)(5), neck (1) and cheek (2). In five cases of papillary carcinoma, skin metastases were located only in the scalp (5)(6)(7)(8), and in one case there were multiple sites of dissemination, i.e.…”

“…Metastases from follicular carcinomas were located in the scalp (1,(3)(4)(5), neck (1) and cheek (2). In five cases of papillary carcinoma, skin metastases were located only in the scalp (5)(6)(7)(8), and in one case there were multiple sites of dissemination, i.e. scalp, cheek, shoulder, arm, abdomen and thigh (6).…”