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Distinct Clinical Manifestations of Thyroid Cancer After Hematopoietic Stem Cell Transplantation

  • Endocrine Tumors
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Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The incidence of a secondary solid malignancy after hematopoietic cell transplantation (HCT) is increasing in long-term survivors.

Objective

The aim of this study was to compare the clinicopathological characteristics of HCT recipients with secondary thyroid cancer (STC), with those of non-HCT thyroid cancer patients.

Methods

We retrospectively investigated 5184 patients who received HCT between 1983 and 2016. Of these, 18 patients developed STC and underwent thyroidectomy due to differentiated thyroid cancer. We compared the clinicopathological characteristics of post-HCT thyroid cancer patients (post-HCT group) with those of a primary differentiated thyroid carcinoma cohort (cohort group) from Seoul St. Mary’s Hospital.

Results

The mean ages at HCT and thyroidectomy after HCT were 22.0 and 31.8 years, respectively, and the median time interval between HCT and thyroidectomy was 5 years (range 1–16). Compared with the cohort group, the post-HCT group was younger at cancer onset and frequently had a palpable mass at initial diagnosis. The post-HCT group had more aggressive features, including larger tumor size, frequent extrathyroidal extension, lymphatic invasion, perineural invasion, and frequent lateral neck node metastasis and distant metastasis, relative to the cohort group; however, most patients (83.2%) in the post-HCT group were stage I or II. Additionally, BRAF V600E mutation was less frequent in the post-HCT group.

Conclusions

We found that STC after HCT showed younger presentation and more aggressive clinical presentation. Therefore, a policy of regular screening, including neck ultrasound examination, may promote early detection and treatment in HCT recipients.

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Authors and Affiliations

  1. Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Tae Yoon Lee MD, Sohee Lee MD, PhD, Ja Seong Bae MD, PhD & Woo-Chan Park MD, PhD

  2. Department of Hematology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Sung-Soo Park MD, PhD, Sung-Eun Lee MD, PhD & Jong Wook Lee MD, PhD

  3. Department of Pediatrics, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Seong Koo Kim MD & Bin Cho MD, PhD

  4. Department of Hospital Pathology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Chan Kwon Jung MD, PhD

Authors
  1. Tae Yoon Lee MD
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  2. Sohee Lee MD, PhD
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  3. Ja Seong Bae MD, PhD
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  4. Woo-Chan Park MD, PhD
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  5. Sung-Soo Park MD, PhD
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  6. Sung-Eun Lee MD, PhD
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Correspondence to Sohee Lee MD, PhD.

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Lee, T.Y., Lee, S., Bae, J.S. et al. Distinct Clinical Manifestations of Thyroid Cancer After Hematopoietic Stem Cell Transplantation. Ann Surg Oncol 26, 3586–3592 (2019). https://doi.org/10.1245/s10434-019-07442-4

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  • DOI: https://doi.org/10.1245/s10434-019-07442-4

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