Thyroid metastasis from lung adenocarcinoma with EML4-ALK rearrangement

Abstract

Thyroid metastases from lung cancer are very rare. A woman aged 42 years with a tumour in the lower lobe of the right lung was diagnosed as having lung adenocarcinoma positive for echinoderm microtubule-associated proteinlike 4-anaplastic lymphoma kinase. Positron emission tomography demonstrated fluorodeoxyglucose accumulation in the lower lobe of the right lung, the right thyroid lobe and both adrenal glands. We performed fine-needle aspiration biopsy (FNAB) and used reverse transcriptase-PCR (RT-PCR) to diagnose the patient as having metastatic lung adenocarcinoma to the thyroid gland. We believe that FNAB combined with RT-PCR can be an effective method for diagnosing metastatic lung adenocarcinoma to the thyroid gland.

Metastatic lung carcinoma in thyroid aspirates: A case series and literature review illustrating diagnostic challenges

“…A total of 21 relevant articles were retrieved during the initial literature search, with three additional articles included after reviewing the references 11–33 . One of the articles was excluded because of a lack of full access 34 .…”

“…Therapeutically, EGFR and ALK status of lung carcinomas are crucial for planning systemic treatment, 46 particularly in patients with metastatic disease. Detection of these mutations is possible on liquidbased preparation residues as stated in the reported cases, 11,15 and in cell block preparations as described in this cohort.…”

Thyroid metastasis revealing a lung adenocarcinoma: A case report and review of the literature

“…Only a few cases of primary lung adenocarcinoma were reported. Research of English language reports using the keywords “lung adenocarcinoma and thyroid metastasis” revealed only 13 cases of thyroid metastasis from pulmonary adenocarcinoma ( Table 1 ) [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] .…”

Issues with the targeted therapy of non‑small cell lung cancer with thyroid metastases: A case report

“…Patients with metastatic lung adenocarcinomas that are ALK-positive have a better prognosis and respond well to ALK inhibitor therapies. ALK inhibitors have been used in tumor-targeted medicines to achieve progression-free survival and an improved quality of life ( 1 , 4 , 5 ). Since the introduction of the first-generation ALK TKI, crizotinib, more selective second-generation (brigatinib and alectinib) and third-generation (lorlatinib) TKIs have been developed; however, resistance mechanisms complicate treatment.…”

“…Since the introduction of the first-generation ALK tKI, crizotinib, more selective second-generation (brigatinib and alectinib) and third-generation (lorlatinib) tKIs have been developed; however, resistance mechanisms complicate treatment. However, there are still numerous unresolved questions and additional research is warranted (1,(4)(5)(6).…”