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Unusual Thyroid Carcinoma Metastases: a Case Series and Literature Review

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Abstract

The most common sites of metastatic differentiated thyroid cancer are the neck lymph nodes, while distant metastases typically involve the lungs, the bones, and less frequently the brain. Uncommon metastatic sites include the liver, adrenal gland, kidney, pancreas, and skin. The epidemiological aspects of thyroid metastases in rare sites are largely unknown and their identification could have a significant impact on patients management. A mini-series of unusual metastatic sites of thyroid carcinoma is proposed as a contribution to current knowledge on anatomopathological characteristics and clinical outcome. Of the six cases that were assessed, the metastases were the following: skin metastases (2), skin and pancreas metastases (1), renal metastasis (1), adrenal metastasis (1), and liver metastasis (1). In our experience, metastases in rare sites do not always represent a negative prognostic factor for disease outcome. In fact they can occur as single distant lesion and if surgically resectable, their treatment can also lead to local disease remission.

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References

  1. Alwaheeb S, Ghazariian D, Boerner SL, Asa SL. Cutaneous manifestation of thyroid cancer: a report of four cases and a review of the literature. J Clin Pathol 57:435–43, 2004.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  2. Htwe TT, Karim N, Lam AKY. Follicular thyroid carcinoma with insular component: a retrospective case study, immunohistochemical analysis and literature review. Singapore Med J 53:e49-51, 2012.

    CAS  PubMed  Google Scholar 

  3. Aghasi MR, Valizadeh N, Soltani S. A 64 year-old female with scalp metastasis of papillary thyroid cancer. Indian J Endocrinol Metab 15(Suppl 2):S136-7, 2011

    PubMed Central  PubMed  Google Scholar 

  4. Bruglia M, Palmonella G, Silvetti F, et al. Skin and thigh muscle metastasis from papillary thyroid cancer. Singapore Med J 50:e61-4, 2009

    CAS  PubMed  Google Scholar 

  5. Song HJ, Xue YL, Xu YH, Qiu ZL, Luo QY. Rare metastases of differentiated thyroid carcinoma: pictorial review. Endocr Relat Cancer 18:R165-74, 2011.

    Article  CAS  PubMed  Google Scholar 

  6. Gomez Hernandez K, Hafezi-Bakhtiari S, Pierre A, et al. Metastatic thyroid carcinoma to the gastric body. J Clin Endocrinol Metab 99:3958–9, 2014.

    Article  PubMed  Google Scholar 

  7. Lee B, Cook G, John L, Harrington K, Nutting C. Follicular thyroid carcinoma metastasis to the esophagus detected by 18FDG PET/CT. Thyroid 18:267–71, 2008.

    Article  PubMed  Google Scholar 

  8. Panoussopoulos D, Theodoropoulos G, Vlahos K, Lazaris ACh, Papadimitriou K. Distant solitary skeletal muscle metastasis from papillary thyroid carcinoma. Int Surg 92:226–9, 2007.

  9. Grimm MO, Spiegelhalder P, Heep H, Gerharz CD, Röher HD, Ackermann R. Penile metastasis secondary to follicular thyroid carcinoma. Scand J Urol Nephrol 38:253–5, 2004.

    Article  PubMed  Google Scholar 

  10. Ozpacaci T, Mulazimoglu M, Tamam MO, et al. Intraocular and orbital metastasis as a rare form of clinical presentation of insular thyroid cancer. Ann Endocrinol (Paris) 73:222–4, 2012.

    Article  Google Scholar 

  11. Guignier B, Naoun O, Subilia A, Schneegans O. Choroidal metastasis from follicular thyroid carcinoma: a rare case. J Fr Ophtalmol 34:329.e1-5, 2011.

    CAS  Google Scholar 

  12. Sarda AK, Pandey D, Bhalla SA, Goyal A. Isolated submandibular gland metastasis from an occult papillary thyroid cancer. Indian J Cancer 41:89–91, 2004.

    CAS  PubMed  Google Scholar 

  13. Avram AM, Gielczyk R, Su L, Vine AK, Sisson JC. Choroidal and skin metastases from papillary thyroid cancer: case and a review of the literature. J Clin Endocrinol Metab 89:5303–7, 2004.

    Article  CAS  PubMed  Google Scholar 

  14. Lim KH, Lee KW, Kim JH, Park SY, Choi SH, Lee JS. Anaplastic thyroid carcinoma initially presented with abdominal cutaneous mass and hyperthyroidism. Korean J Intern Med 25:450–3, 2010.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Shon W, Ferguson SB, Comfere NI. Metastatic Hürthle cell carcinoma of the thyroid presenting as ulcerated scrotum nodules. Am J Dermatopathol 32:392–4, 2010.

    PubMed  Google Scholar 

  16. Durante C, Haddy N, Baudin E, et al. Long-term outcome of 444 patients with distant metastases from papillary and follicular thyroid carcinoma: benefits and limits of radioiodine therapy. J Clin Endocrinol Metab 91:2892–9, 2006.

    Article  CAS  PubMed  Google Scholar 

  17. Madani A, Jozaghi Y, Tabah R, How J, Mitmaker E. Rare metastases of well-differentiated thyroid cancers: a systematic review. Ann Surg Oncol 22:460–6, 2015.

    Article  PubMed  Google Scholar 

  18. Koller BA, Tourtelot JB, Pak HS, Cobb MW, Moad JC, Flynn EA. Papillary and follicular thyroid carcinoma metastatic to the skin: a case report and a review of the literature. Thyroid 8:1045–50, 1998.

    Article  CAS  PubMed  Google Scholar 

  19. Dahl PR, Brodland DG, Goellner JR, Hay ID. Thyroid carcinoma metastatic to the skin: a cutaneous manifestation of a widely disseminated malignancy. J Am Acad Dermatol 36:531–7, 1997.

    Article  CAS  PubMed  Google Scholar 

  20. Quinn TR, Duncan LM, Zembowicz A, Faquin WC. Cutaneous metastases of follicular thyroid carcinoma: a report of four cases and a review of the literature. Am J Dermatopathol 27:306–12, 2005.

    Article  PubMed  Google Scholar 

  21. McIver B, Hay ID, Giuffrida DF, et al. Anaplastic thyroid carcinoma: a 50-year experience at a single institution. Surgery 130:1028–34, 2001.

    Article  CAS  PubMed  Google Scholar 

  22. Luo QY, Luo Q, Chen LB, Yu YL, Lu HK, Zhu RS. Multiple subdermal metastases from papillary thyroid cancer. Thyroid 18:907–8, 2008.

    Article  PubMed  Google Scholar 

  23. Kwon H, Kim H, Park S, et al. Solitary skin metastasis of papillary thyroid carcinoma. Endocrinol Metab 29:579–83, 2014

    Article  Google Scholar 

  24. Tunio MA, AlAsiri M, Riaz K, AlShakweer W. Pancreas as Delayed Site of Metastasis from Papillary Thyroid Carcinoma. Case Rep Gastrointest Med 2013:386263, 2013

  25. Layfield LJ, Hirschowitz SL, Adler DG. Metastatic disease to the pancreas documented by endoscopic ultrasound guided fine-needle aspiration: a seven-year experience. Diagn Cytopathol 40:228–33, 2012.

    Article  PubMed  Google Scholar 

  26. Li XO, Li ZP, Wang P, et al. Pancreatic metastasis of papillary thyroid carcinoma: a case report with review of the literature. Int J Clin Exp Pathol 7:819–22, 2014.

    PubMed Central  PubMed  Google Scholar 

  27. Borschitz T, Eichhorn W, Fottner C, et al. Diagnosis and treatment of pancreatic metastases of a papillary thyroid carcinoma. Thyroid 20:93–8, 2010.

    Article  PubMed Central  PubMed  Google Scholar 

  28. Siddiqui AA, Olansky L, Sawh RN, Tierney WM. Pancreatic metastasis of tall cell variant of papillary thyroid carcinoma: diagnosis by endoscopic ultrasound-guided fine needle aspiration. JOP 7:417–22, 2006.

    PubMed  Google Scholar 

  29. Davis RI, Corson JM. Renal metastases from well differentiated follicular thyroid carcinoma: a case report with light and electron microscopic findings. Cancer 43:265–8, 1979.

    Article  CAS  PubMed  Google Scholar 

  30. Xu H, Zeng W, Tang Y. Metastatic thyroid follicular carcinoma presenting as a primary renal tumor. Intern Med 51:2193–6, 2012.

    Article  PubMed  Google Scholar 

  31. Pelttari H, Välimäki MJ, Löyttyniemi E, Schalin-Jäntti C. Post-ablative serum thyroglobulin is an independent predictor of recurrence in low-risk differentiated thyroid carcinoma: a 16-year follow-up study. Eur J Endocrinol 163:757–63, 2010.

    Article  CAS  PubMed  Google Scholar 

  32. Koutkia P, Safer JD. Adrenal metastasis secondary to papillary thyroid carcinoma. Thyroid 11:1077–9, 2001.

    Article  CAS  PubMed  Google Scholar 

  33. Orsolon P, Bagni B, Geatti O, Guerra UP. An unusual adrenal metastasis secondary to Hürthle cell carcinoma of the thyroid. Clin Nucl Med 21:312–5, 1996.

    Article  CAS  PubMed  Google Scholar 

  34. Batawil N. Papillary thyroid cancer with bilateral adrenal metastases. Thyroid 23:1651–4, 2013.

    Article  PubMed  Google Scholar 

  35. Kumar A, Nadig M, Patra V, Srivastava DN, Verma K, Bal CS. Adrenal and renal metastases from follicular thyroid cancer. Br J Radiol 78:1038–41, 2005.

    Article  CAS  PubMed  Google Scholar 

  36. Salvatori M, Perotti G, Rufini V, et al. Solitary liver metastasis from Hürthle cell thyroid cancer: a case report and review of the literature. J Endocrinol Invest 27:52–6, 2004.

    Article  CAS  PubMed  Google Scholar 

  37. Kondo T, Katoh R, Omata K, Oyama T, Yagawa A, Kawaoi A. Incidentally detected liver metastasis of well-differentiated follicular carcinoma of the thyroid, mimicking ectopic thyroid. Pathol Int 50:509–13, 2000.

    Article  CAS  PubMed  Google Scholar 

  38. Djenic B, Duick D, Newell JO, Demeure MJ. Solitary liver metastasis from follicular variant papillary thyroid carcinoma: a case report and literature review. Int J Surg Case Rep 6C:146–9, 2015.

    Article  PubMed  Google Scholar 

  39. Kraft O. Hepatic metastasis of differentiated thyroid carcinoma. Nucl Med Rev Cent East Eur 8:44–6, 2005.

    PubMed  Google Scholar 

  40. Krajewska J, Handkiewicz-Junak D, Jarzab B. Sorafenib for the treatment of thyroid cancer: an updated review. Expert Opin Pharmacother 16:573–83, 2015.

    Article  CAS  PubMed  Google Scholar 

  41. Thomas L, Lai SY, Dong W, et al. Sorafenib in metastatic thyroid cancer: a systematic review. Oncologist 19:251–8, 2014.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  42. Malhotra G, Upadhye TS, Sridhar E, et al. Unusual case of adrenal and renal metastases from papillary carcinoma of thyroid. Clin Nucl Med 35:731–6, 2010.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors are grateful to Milly Buwenge B.Sc. for reviewing the manuscript and to Paolo Cipressi and Cinzia Giacometti for their contribution in graphic art.

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    Authors and Affiliations

    1. Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine–DIMES, University of Bologna, S. Orsola-Malpighi Hospital, Via Massarenti 9, 40135, Bologna, Italy

      Eleonora Farina, Fabio Monari, Silvia Cammelli & Alessio G. Morganti

    2. Anatomic Pathology, Department of Experimental, Diagnostic and Specialty Medicine–DIMES, Bellaria Hospital, University of Bologna, Via Altura 3, 40139, Bologna, Italy

      Giovanni Tallini

    3. Division of Endocrinology, University of Bologna, S. Orsola-Malpighi Hospital, Via Massarenti 9, 40135, Bologna, Italy

      Andrea Repaci & Renato Pasquali

    4. Radiotherapy Unit, Azienda Ospedaliera Universitaria Integrata, Ospedale Civile Maggiore, Piazzale Aristide Stefani 1, Verona, Italy

      Renzo Mazzarotto

    5. Pathology Unit of the “F. Addarii” Institute of Oncology, Department of Oncology and Hematology, University of Bologna, S. Orsola-Malpighi Hospital, Via Massarenti 9, 40135, Bologna, Italy

      Francesca Giunchi & Michelangelo Fiorentino

    6. Department of Pathology, University of Bologna, S. Orsola-Malpighi Hospital, Via Massarenti 9, 40135, Bologna, Italy

      Riccardo Panzacchi

    7. Radiation Oncology Department, The Lacks Cancer Center, Saint Mary’s Health Care, 250 Cherry St SE, Grand Rapids, MI, 49503, USA

      Gilbert D. A. Padula

    8. Radiation Oncology Unit, Fondazione “Giovanni Paolo II”, Catholic University of Sacred Heart, Largo Agostino Gemelli, 1, 86100, Campobasso, Italy

      Francesco Deodato

    9. Nuclear Medicine Unit, University of Bologna, S. Orsola-Malpighi Hospital, Via Massarenti 9, 40135, Bologna, Italy

      Stefano Fanti

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    1. Eleonora Farina
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    2. Fabio Monari
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    3. Giovanni Tallini
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    4. Andrea Repaci
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    Correspondence to Fabio Monari.

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    The authors declare that they have no competing interests.

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    The study was approved by the local Ethics Committee.

    Informed consent was obtained from all individual participants included in the study.

    This article does not contain any studies with human participants or animals performed by any of the authors.

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    Michelangelo Fiorentino and Alessio G. Morganti contributed equally to this work.

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    Farina, E., Monari, F., Tallini, G. et al. Unusual Thyroid Carcinoma Metastases: a Case Series and Literature Review. Endocr Pathol 27, 55–64 (2016). https://doi.org/10.1007/s12022-015-9410-7

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    • DOI: https://doi.org/10.1007/s12022-015-9410-7

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