Advertisement

Endocrine Pathology

, Volume 27, Issue 1, pp 55–64 | Cite as

Unusual Thyroid Carcinoma Metastases: a Case Series and Literature Review

  • Eleonora Farina
  • Fabio MonariEmail author
  • Giovanni Tallini
  • Andrea Repaci
  • Renzo Mazzarotto
  • Francesca Giunchi
  • Riccardo Panzacchi
  • Silvia Cammelli
  • Gilbert D. A. Padula
  • Francesco Deodato
  • Renato Pasquali
  • Stefano Fanti
  • Michelangelo Fiorentino
  • Alessio G. Morganti
Article

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.

Keywords

Thyroid cancer Cutaneous metastasis Pancreatic metastasis Renal metastasis Adrenal metastasis Liver metastasis 

Notes

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.

Compliance with Ethical Standards

Funding

The manuscript has no funding.

Conflicts of Interest

The authors declare that they have no competing interests.

Ethical Approval

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.

References

  1. 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.PubMedCentralCrossRefPubMedGoogle Scholar
  2. 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.PubMedGoogle Scholar
  3. 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, 2011PubMedCentralPubMedGoogle Scholar
  4. 4.
    Bruglia M, Palmonella G, Silvetti F, et al. Skin and thigh muscle metastasis from papillary thyroid cancer. Singapore Med J 50:e61-4, 2009PubMedGoogle Scholar
  5. 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.CrossRefPubMedGoogle Scholar
  6. 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.CrossRefPubMedGoogle Scholar
  7. 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.CrossRefPubMedGoogle Scholar
  8. 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.Google Scholar
  9. 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.CrossRefPubMedGoogle Scholar
  10. 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.CrossRefGoogle Scholar
  11. 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.Google Scholar
  12. 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.PubMedGoogle Scholar
  13. 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.CrossRefPubMedGoogle Scholar
  14. 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.PubMedCentralCrossRefPubMedGoogle Scholar
  15. 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.PubMedGoogle Scholar
  16. 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.CrossRefPubMedGoogle Scholar
  17. 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.CrossRefPubMedGoogle Scholar
  18. 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.CrossRefPubMedGoogle Scholar
  19. 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.CrossRefPubMedGoogle Scholar
  20. 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.CrossRefPubMedGoogle Scholar
  21. 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.CrossRefPubMedGoogle Scholar
  22. 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.CrossRefPubMedGoogle Scholar
  23. 23.
    Kwon H, Kim H, Park S, et al. Solitary skin metastasis of papillary thyroid carcinoma. Endocrinol Metab 29:579–83, 2014CrossRefGoogle Scholar
  24. 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, 2013Google Scholar
  25. 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.CrossRefPubMedGoogle Scholar
  26. 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.PubMedCentralPubMedGoogle Scholar
  27. 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.PubMedCentralCrossRefPubMedGoogle Scholar
  28. 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.PubMedGoogle Scholar
  29. 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.CrossRefPubMedGoogle Scholar
  30. 30.
    Xu H, Zeng W, Tang Y. Metastatic thyroid follicular carcinoma presenting as a primary renal tumor. Intern Med 51:2193–6, 2012.CrossRefPubMedGoogle Scholar
  31. 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.CrossRefPubMedGoogle Scholar
  32. 32.
    Koutkia P, Safer JD. Adrenal metastasis secondary to papillary thyroid carcinoma. Thyroid 11:1077–9, 2001.CrossRefPubMedGoogle Scholar
  33. 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.CrossRefPubMedGoogle Scholar
  34. 34.
    Batawil N. Papillary thyroid cancer with bilateral adrenal metastases. Thyroid 23:1651–4, 2013.CrossRefPubMedGoogle Scholar
  35. 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.CrossRefPubMedGoogle Scholar
  36. 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.CrossRefPubMedGoogle Scholar
  37. 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.CrossRefPubMedGoogle Scholar
  38. 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.CrossRefPubMedGoogle Scholar
  39. 39.
    Kraft O. Hepatic metastasis of differentiated thyroid carcinoma. Nucl Med Rev Cent East Eur 8:44–6, 2005.PubMedGoogle Scholar
  40. 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.CrossRefPubMedGoogle Scholar
  41. 41.
    Thomas L, Lai SY, Dong W, et al. Sorafenib in metastatic thyroid cancer: a systematic review. Oncologist 19:251–8, 2014.PubMedCentralCrossRefPubMedGoogle Scholar
  42. 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.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Eleonora Farina
    • 1
  • Fabio Monari
    • 1
    Email author
  • Giovanni Tallini
    • 2
  • Andrea Repaci
    • 3
  • Renzo Mazzarotto
    • 4
  • Francesca Giunchi
    • 5
  • Riccardo Panzacchi
    • 6
  • Silvia Cammelli
    • 1
  • Gilbert D. A. Padula
    • 7
  • Francesco Deodato
    • 8
  • Renato Pasquali
    • 3
  • Stefano Fanti
    • 9
  • Michelangelo Fiorentino
    • 5
  • Alessio G. Morganti
    • 1
  1. 1.Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine–DIMESUniversity of Bologna, S. Orsola-Malpighi HospitalBolognaItaly
  2. 2.Anatomic Pathology, Department of Experimental, Diagnostic and Specialty Medicine–DIMESBellaria Hospital, University of BolognaBolognaItaly
  3. 3.Division of EndocrinologyUniversity of Bologna, S. Orsola-Malpighi HospitalBolognaItaly
  4. 4.Radiotherapy UnitAzienda Ospedaliera Universitaria Integrata, Ospedale Civile MaggioreVeronaItaly
  5. 5.Pathology Unit of the “F. Addarii” Institute of Oncology, Department of Oncology and HematologyUniversity of Bologna, S. Orsola-Malpighi HospitalBolognaItaly
  6. 6.Department of PathologyUniversity of Bologna, S. Orsola-Malpighi HospitalBolognaItaly
  7. 7.Radiation Oncology Department, The Lacks Cancer CenterSaint Mary’s Health CareGrand RapidsUSA
  8. 8.Radiation Oncology Unit, Fondazione “Giovanni Paolo II”Catholic University of Sacred HeartCampobassoItaly
  9. 9.Nuclear Medicine UnitUniversity of Bologna, S. Orsola-Malpighi HospitalBolognaItaly

Personalised recommendations