Thyroid carcinoma metastatic to the skin: A cutaneous manifestation of a widely disseminated malignancy

Dahl, Patrick R.; Brodland, David G.; Goellner, John R.; Hay, Ian D.

doi:10.1016/s0190-9622(97)70239-1

Cited by 114 publications

(159 citation statements)

References 36 publications

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“…In the context of thyroid carcinoma metastases, immunoperoxidase staining for thyroglobulin, a 670 kd glycoprotein synthesized in the cytoplasm of follicular thyroid epithelium is an important method to determine the tissue of origin. [2] Thyroglobulin has been demonstrated to be present in normal thyroid tissue, goiters, thyroiditis and thyroid carcinomas originating from follicular cells. Thyroglobulin expression is specific to carcinomas of thyroid follicular cell derivation, including both papillary and follicular types, but is not found in lung carcinomas.…”

Section: Immunohistochemical Methodsmentioning

confidence: 99%

“…[2] Most commonly the neoplasms metastasizing to cutaneous areas are melanomas, cancers of colon, lungs and breast. Cutaneous metastasis from thyroid carcinoma is rare.…”

Section: Overviewmentioning

confidence: 99%

“…Cutaneous metastasis from thyroid carcinoma is rare. Dahl et al [2] reported 43 cases of thyroid carcinoma with skin metastasis in their review of the literature between 1964 and 1997. Papillary thyroid carcinoma (PTC) was the most common histologic type representing 41% of cases.…”

Section: Overviewmentioning

confidence: 99%

“…[2] The metastatic lesion appeared 5 months after the diagnosis of thyroid anaplastic carcinoma on the left temple as 4x3 cm flesh-colored mass. The patient died 4 months later of metastatic disease.…”

Section: Anaplastic Carcinomamentioning

confidence: 99%

“…[2] Metastaic scalp lesions can vary in appearance and might be misdiagnosed as benign or primary skin tumors. Therefore a high index of suspicion is necessary to reach the exact diagnosis.…”

mentioning

confidence: 99%

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

Arslan¹

2014

J Med Updates

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Thyroid carcinoma represents 1% to 1.5% of all cancer cases reported annualy and accounts for 57% of all deaths caused by endocrine malignancies. [1] Well-differentiated thyroid carcinomas including papillary and follicular carcinoma are the most common thyroid malignancies comprising approximately 70% and 10% respectively, of all cases. Scalp as a distinct cutaneous area has a rich dermal vasculature and is a site of various primary and metastatic neoplasms. Different visceral malignancies such as cancers of lung, breast, thyroid, colon, kidney, adrenal glands and larynx can metastasize to scalp. Metastases to scalp from thyroid carcinomas are extremely rare and demonstrate advanced disease and poor prognosis. Such lesions may indicate treatment failure or alternatively they may be the ÖzetBu derlemede literatürde skalp metastaz› yapt›¤› bildirilen tiroid karsinom vakalar› taranarak tan›sal, histopatolojik ve prognostik özellik-leri ile tart›fl›ld›. PubMed ve MedLine servislerinde yay›nlanan tüm tiroid karsinomlar›na ba¤l› skalp metastaz› vakalar› araflt›r›ld› ve hastalar›n yafl ve cinsiyetine, tiroid karsinomunun histolojik tipine, skalp d›fl›nda cilt alanlar›na metastazlar›na ve primer tümörün teflhisiyle metastaz teflhisi aras›ndaki süreye iliflkin verilere ulaflmak için hasta bilgileri incelendi. Literatürde günümüze kadar bildirilen 38 vaka bulundu. Bildirilen vakalarda en s›k görülen histolojik tip foliküler karsinom (%46) idi. Papiller karsinom, medüller karsinom ve anaplastik karsinom vakalar›n›n oranlar› ise s›ras›yla %35, %16 ve %3 olarak bulundu. Özel bir cilt alan› olan skalp zengin bir damar a¤›na ve kanlanmaya sahip olup çeflitli primer veya metastatik tümörlerin oda¤› olabilir. Tiroid karsinomlar›na ba¤l› skalp metastazlar› oldukça nadir olup ilerlemifl hastal›¤a ve kötü prognoza iflaret eder. Düflük metastatik potansiyele sahip gizli bir neoplazm›n ilk belirtisi olarak ç›kabilen bir skalp nodülünün teflhisi oldukça güç olabilir. Tiroid karsinomlar›-n›n histopatolojik özelliklerinin ve cilt metastaz› kal›plar›n›n bilinmesiyle bu gibi lezyonlar›n tan›s›na daha kolay ulafl›labilir.Anahtar sözcükler: Metastaz, skalp, tiroid karsinomu. AbstractThyroid carcinomas reported to metastasize to scalp were reviewed and discussed with histopathological, prognostic and diagnostic aspects. All cases of scalp metastasis from thyroid carcinomas published in PubMed and MedLine were reviewed and the data of all patients were analyzed to obtain information about the patient demographics, histologic type of thyroid carcinoma, additional cutaneous sites, time interval between the diagnosis of the primary tumor and the diagnosis of scalp metastasis. The literature review revealed 38 cases of scalp metastasis from thyroid carcinoma. The most common histologic type was follicular carcinoma (46%), followed by papillary (35%), medullary (16%) and anaplastic carcinomas (3%). Scalp as a distinct cutaneous area has a rich dermal vasculature and is a site of various primary and metastatic neoplasms. Metastases to scalp from ...

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Section: Immunohistochemical Methodsmentioning

confidence: 99%

“…[2] Most commonly the neoplasms metastasizing to cutaneous areas are melanomas, cancers of colon, lungs and breast. Cutaneous metastasis from thyroid carcinoma is rare.…”

Section: Overviewmentioning

confidence: 99%

Section: Overviewmentioning

confidence: 99%

Section: Anaplastic Carcinomamentioning

confidence: 99%

mentioning

confidence: 99%

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

Arslan¹

2014

J Med Updates

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Clinicopathologic features and BRAF^V600E mutation analysis in cutaneous metastases from well‐differentiated thyroid carcinomas

Erickson

Jin

Nakamura

et al. 2007

Cancer

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BACKGROUNDCutaneous metastases from well‐differentiated thyroid carcinomas are rare and are usually identified in patients with widely disseminated disease. Occasionally, thyroid carcinomas can present as cutaneous metastases for which the primary site needs to be determined. Papillary thyroid carcinomas (PTCs) commonly have BRAFV600E mutation. A series of 16 cutaneous metastases were analyzed from well‐differentiated thyroid carcinomas to learn more about the clinicopathologic features and BRAFV600E mutation status.METHODSEleven cases of PTC and 5 of follicular thyroid carcinoma (FTC) metastatic to the skin were evaluated. All cutaneous metastases were studied histologically and with thyroglobulin and thyroid transcription factor immunostains. All tumor samples were analyzed for mutations at nucleotide 1799 in exon 15 of the BRAF gene.RESULTSTwo patients with FTC presented with cutaneous metastases. Fourteen of 16 patients died of disease and 2 were alive with disease at follow‐up. The histologic features of the cutaneous metastases were generally characteristic of the primary tumor; however, 2 of the 11 PTC metastases demonstrated cytoplasmic clearing not typical of classic PTC. BRAFV600E mutation (T1799A) was detected in 5 of 11 cases of PTC and in none of the 5 FTCs.CONCLUSIONSCutaneous metastases from PTC may show prominent clear cell change requiring differentiation from clear cell hidradenoma, clear cell dermatofibroma, malignant melanoma with prominent clear cell change, and cutaneous metastasis from renal cell carcinoma. BRAFV600E mutation is identified in a subset of cutaneous metastases from PTC. Cutaneous metastases from PTC and FTC are associated with a very poor prognosis. Cancer 2007. © 2007 American Cancer Society.

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Fine needle aspiration cytology of unsuspected metastatic hurthle cell carcinoma of the thyroid and its pitfalls: A report of two cases

Lallu

Naran

Bethwaite

2007

Diagnostic Cytopathology

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We discuss two cases of unsuspected metastatic thyroid carcinoma of Hurthle cell type, presenting as subcutaneous masses in the occipital scalp and supra-acetabular region of the right ilium; clinically suspected to be a lipoma and a vascular tumour, respectively. These two cases were initially investigated by fine-needle aspiration cytology. In case 1, a definitive diagnosis of metastatic Hurthle cell carcinoma was made based on cell block preparation and positive immunohistochemical stains for thyroglobulin and thyroid transcription factor-1. Case 2 was reported as suggesting an oncocytic process, metastatic Hurthle cell lesion. The filter preparations from both cases showed compact sheets and individual large polygonal cells with voluminous granular cytoplasm, eccentric nuclei with minimal atypia and bland chromatin. Scattered haemosiderin-laden macrophages and cystic debris were also identified in both cases. These cases are of interest as the bland cytologic features may lead to an erroneous benign diagnosis. Immunohistochemistry aids the definitive diagnosis of metastatic Hurthle cell carcinoma of thyroid especially when the presence of a previous thyroid lesion is not communicated to the laboratory.

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Thyroid carcinoma metastatic to the skin: A cutaneous manifestation of a widely disseminated malignancy

Cited by 114 publications

References 36 publications

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

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

Clinicopathologic features and BRAF^V600E mutation analysis in cutaneous metastases from well‐differentiated thyroid carcinomas

Fine needle aspiration cytology of unsuspected metastatic hurthle cell carcinoma of the thyroid and its pitfalls: A report of two cases

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Thyroid carcinoma metastatic to the skin: A cutaneous manifestation of a widely disseminated malignancy

Cited by 114 publications

References 36 publications

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

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

Clinicopathologic features and BRAFV600E mutation analysis in cutaneous metastases from well‐differentiated thyroid carcinomas

Fine needle aspiration cytology of unsuspected metastatic hurthle cell carcinoma of the thyroid and its pitfalls: A report of two cases

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Clinicopathologic features and BRAF^V600E mutation analysis in cutaneous metastases from well‐differentiated thyroid carcinomas