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Endocrine Pathology

, Volume 28, Issue 2, pp 112–120 | Cite as

Diagnosis and Treatment of Metastases to the Thyroid Gland: a Meta-Analysis

  • Patrizia Straccia
  • Claudia Mosseri
  • Chiara Brunelli
  • Esther Diana Rossi
  • Celestino Pio Lombardi
  • Alfredo Pontecorvi
  • Guido FaddaEmail author
Article
First Online:

Abstract

The thyroid is a rare site of clinically detectable tumor metastases; even though the gland is a highly vascularized structure, the frequency of metastases in the routine practice is less than 0.2% of all thyroid malignancies. The purpose of our meta-analysis is to evaluate the frequency of metastatic diffusion from other primary tumors to the thyroid gland and to suggest the best possible treatment through an evidence-based study. Relevant studies were identified by searching the following databases: PubMed, Scopus, and Web of Science. We selected all English-written articles published from 1995 to 2015. Studies were considered eligible if they reported the timing of metastatic spread and the site of the primary tumor in respect to the diaphragmatic region. Case reports were not included. Twenty-eight studies accounted for 514 patients. The rate of metachronous metastases was 69%. Fifty-three percent of primaries originated from the infradiaphragmatic region. Fine needle aspiration biopsy (FNAB) was done in 154 patients and 195 patients were treated mostly with surgery. A prevalence of primary tumors from the infradiaphragmatic region and of metachronous metastases was observed. Knowledge of the clinical history and the ancillary techniques can improve the sensitivity and accuracy of FNAB. Thyroidectomy may be considered a more effective treatment than radio-chemotherapy.

Keywords

Meta-analysis Thyroid neoplasm Metastasis Diagnosis Surgery 
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Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Papi G, Fadda G, Corsello SM et al (2007) Metastases to the thyroid gland: prevalence, clinicopathological aspects and prognosis: a 10 year experience. Cinical Endocrinol (Oxf) 66: 565–571.Google Scholar
  2. 2.
    Smith SA, Gharib H, Goellner JR. (1987) Fine-needle aspiration. Usefulness for diagnosis and management of metastatic carcinoma to the thyroid. Arch Intern Med 147: 311–312.CrossRefPubMedGoogle Scholar
  3. 3.
    Virchow RLK (1859) Die Cellularpathologie in ihrer Begründung auf physiologische undpathologische Gewebelehre. Berlin,: A. HirschwaldGoogle Scholar
  4. 4.
    Berge T, Lundberg S. Cancer in Malmo 1958–1969. An autopsy study. (1977) Acta Pathol Microbiol Scand Suppl 1:235.Google Scholar
  5. 5.
    Nakhjavani MK, Gharib H, Goellner JR, Van Heerden JA (1997a) Metastasis to the thyroid gland. A report of 43 cases. Cancer 79:574–578.CrossRefPubMedGoogle Scholar
  6. 6.
    Mortensen JD,Woolner LB, Bennet WA (1956) Secondary malignant tumors of the thyroid gland. Cancer 9: 306–309.CrossRefPubMedGoogle Scholar
  7. 7.
    Shimaoka K, Sokal JE, Pickren JW (1961) Metastatic neoplasms in the thyroid gland: pathological and clinical findings. Cancer 15: 557–565.CrossRefGoogle Scholar
  8. 8.
    Silverberg SG, Vidone RA (1966) Metastatic tumors in the thyroid. Pacific Med Surg 74: 175–178.Google Scholar
  9. 9.
    Chung AY, Tran TB, Brumund KT, Weisman RA , Bouvet M (2012) Metastases to the thyroid: a review of the literature from the last decade. Thyroid 22:258–268.CrossRefPubMedGoogle Scholar
  10. 10.
    Mattavelli F, Collini P, Pizzi N, Nicolai N, Pennacchioli E; Thyroid Study Group (2008) Thyroid as a target of metastases. A case of foregut neuroendocrine carcinoma with multiple abdominal metastases and a thyroid localization after 21 years. Tumori 94:110–113.CrossRefPubMedGoogle Scholar
  11. 11.
    Nakhjavani MK, Gharib H, Goellner JR , van Heerden JA (1997b) Metastasis to the thyroid gland. A report of 43 cases Cancer 79:574–578.CrossRefPubMedGoogle Scholar
  12. 12.
    Chen H, Nicol TL, Udelsman R. (1999a) Clinically significant, isolated metastatic disease to the thyroid gland. World J Surg 23:177–180.CrossRefPubMedGoogle Scholar
  13. 13.
    Sirota DK, Goldfield EB, Eng YF, Unger AH (1968) Metastatic infiltration of the thyroid gland causing hypothyroidism. J Mt Sinai Hosp N Y 35:242–245.PubMedGoogle Scholar
  14. 14.
    Ridgway EC (1994) Secondary malignancy of the thyroid gland: a case report and review of the literature. Thyroid; 4:297–300.CrossRefPubMedGoogle Scholar
  15. 15.
    Heffess CS, Wenig BM, Thompson LD (2002) Metastatic renal cell carcinoma to the thyroid gland. A clinopathologic study of 36 cases. Cancer 95:1869–1878.CrossRefPubMedGoogle Scholar
  16. 16.
    Kim TY, Kim WB, Gong G, Hong SJ, Shong YK. (2005) Metastasis to the thyroid diagnosed by fine-needle aspiration biopsy. Clin Endocrinology (Oxf). 62:236–241.CrossRefGoogle Scholar
  17. 17.
    Cichon S, Anielski R, Konturek A, Barczynski M, Cichon W. (2006) Metastases to the thyroid gland: seventeen cases operated on in a single clinical center. Langenbecks Arch Surg 391:581–587.CrossRefPubMedGoogle Scholar
  18. 18.
    Wood K, Vini L, Harmer C. (2004) Metastases to the thyroid gland: the Royal Marsden experience Eur J Surg Oncol. 30:583–588.CrossRefPubMedGoogle Scholar
  19. 19.
    Lam KY, Lo CY (1998) Metastatic tumors of the thyroid gland: a study of 79 cases in Chinese patients Arch Pathol Lab Med. 122:37–41.PubMedGoogle Scholar
  20. 20.
    Schroder S, Burk CG, de Heer K. (1987) Metastases of the thyroid gland—morphology and clinical aspects of 25 secondary thyroid neoplasms. Langenbecks Arch Chir 370:25–35.CrossRefPubMedGoogle Scholar
  21. 21.
    Montero PH, Ibrahimpasic T, Nixon IJ, Shaha AR. (2014) Thyroid metastasectomy. J Surg Oncol 109:36–41.CrossRefPubMedGoogle Scholar
  22. 22.
    Chen AY, Jemal A, Ward EM (2009) Increasing incidence of differentiated thyroid cancer in the United States, 1988–2005. Cancer 115:3801–3807.CrossRefPubMedGoogle Scholar
  23. 23.
    Burt A, Goudie RB (1979) Diagnosis of primary thyroid carcinoma by immunohistological demonstration of thyroglobulin. Histopathology 3:279–286.CrossRefPubMedGoogle Scholar
  24. 24.
    Camilleri-Broet S, Alifano M, Morcos M et al (2004) Peroperative frozen section analysis of TTF-1 antigen expression. J Clin Pathol 57(1):98–100.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Dayal Y, Ucci AA, Safaii H, Pohl D (1986) Thyroglobulin and clear cell tumors. Am J Surg Pathol 10:70–72.CrossRefPubMedGoogle Scholar
  26. 26.
    Harach HR, Franssila KO (1988) Thyroglobulin immunostaining in follicular thyroid carcinoma: relationship to the degree of differentiation and cell type. Histopathology 13:43–54.CrossRefPubMedGoogle Scholar
  27. 27.
    Moher D, Liberati A, Tetzlaff J, Altman DG & PRISMA Group 2009. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement [serial online]. PLoS Med 6:e1000097CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Hedges LV, Vevea JL (1998) Fixed- and random-effects models in meta-analysis. Psychol Methods 3:486–504.CrossRefGoogle Scholar
  29. 29.
    Huedo-Medina TB, Sánchez-Meca J, Marín-Martínez F, Botella J (2006)Assessing heterogeneity in meta-analysis: Q statistic or I 2 index? Psychol Methods 11:193–206.CrossRefPubMedGoogle Scholar
  30. 30.
    Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327: 557–560.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Egger M, Davey Smith G, Schneider M, Minder C. (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315: 629–634.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Begg CB, Mazumdar M (1994) Operating characteristics of a rank correlation test for publication bias. Biometrics; 50:1088–1101.CrossRefPubMedGoogle Scholar
  33. 33.
    Aron M, Kapila K, Verma K. (2005) Role of fine-needle aspiration cytology in the diagnosis of secondary tumors of the thyroid—twenty years’ experience. Diagn Cytopathol 34(3):240–245.CrossRefGoogle Scholar
  34. 34.
    Calzolari F, Sartori PV, Talarico C, Parmeggiani D, Beretta E, Pezzullo L, Bovo G, Sperlongano P, Monacelli M, Lucchini R, Misso C, Gurrado A, D’ Ajello M, Uggeri F, Puxeddu E, Nasi P, Testini M, Rosato L, Barbarisio A, Avenia N (2008) Surgical treatment of intrathyroid metastases: preliminary results of a multicentric study. Anticancer Research 28: 2885–2888.PubMedGoogle Scholar
  35. 35.
    Chung SY, Kim EK, Kim JH, Oh KK, Kim DJ, Lee YH, An HJ, Kim JS. (2001) Sonographic findings of metastatic disease to the thyroid. Yonsei Med J 42(4):411–417.CrossRefPubMedGoogle Scholar
  36. 36.
    Gerges AS, Shehata SR, Gouda IA. (2006) Metastasis to the thyroid gland; unusual site of metastasis. J Egypt Natl Canc Inst. 18(1):67–72.PubMedGoogle Scholar
  37. 37.
    Villumsen AL, Mevik K, Fjøsne HE, Brekke MB, Haugen OA (2013) Late onset metastases to the thyroid gland from renal carcinoma. Tidsskr Nor Laegeforen. 133(21):2262–2265.CrossRefPubMedGoogle Scholar
  38. 38.
    Ishikawa M, Hirano S, Tsuji T, Ito J (2011) Management of metastasis to the thyroid gland. Auris Nasus Larynx. 38(3):426–430.CrossRefPubMedGoogle Scholar
  39. 39.
    Lièvre A, Leboulleux S, Boige V et al (2006) Thyroid metastases from colorectal cancer: the Institut Gustave Roussy experience. Eur J Cancer. 42(12):1756–1759.CrossRefPubMedGoogle Scholar
  40. 40.
    Pitale SU, Sizemore GW, Bakhos R, DeJong SA, Flanigan RC, Emanuele NV (2000) Renal cell carcinoma with metastasis to the thyroid gland. Urol Onco 5(4):173–175.CrossRefGoogle Scholar
  41. 41.
    Pusztaszeri M, Wang H, Cibas ES et al (2015) Fine-needle aspiration biopsy of secondary neoplasms of the thyroid gland: a multi-institutional study of 62 cases. Cancer Cytopathol 123(1):19–29.CrossRefPubMedGoogle Scholar
  42. 42.
    De Ridder M, Sermeus AB, Urbain D, Storme GA (2003) Metastases to the thyroid gland—a report of six cases. Eur J Intern Med. 4(6):377–379.CrossRefGoogle Scholar
  43. 43.
    Romero Arenas MA, Ryu H, Lee S, Morris LF, Grubbs EG, Lee JE & Perrier ND (2014)The role of thyroidectomy in metastatic disease to the thyroid gland. Ann Surg Oncol 21:434–439.CrossRefPubMedGoogle Scholar
  44. 44.
    Saito Y, Sugitani I, Toda K, Yamada K, Fujimoto Y. (2014) Metastatic thyroid tumors: ultrasonographic features, prognostic factors and outcomes in 29 cases. Surg Today 44:55–61.CrossRefPubMedGoogle Scholar
  45. 45.
    Kim HK, Kim SS, Oak CY, Kim SJ, Yoon JH, Kang HC (2014)Diffuse metastasis to the thyroid: unique ultrasonographic finding and clinical correlation. J Korean Med Sci 29(6):818–824.CrossRefPubMedPubMedCentralGoogle Scholar
  46. 46.
    Vardar E, Erkan N, Bayol U, Yılmaz C, Dogan M. (2011) Metastatic tumours to the thyroid gland: report of 3 cases and brief review of the literature. Radiol Oncol 45(1):53–58.CrossRefPubMedGoogle Scholar
  47. 47.
    Lee MW, Batoroev YK, Odashiro AN , Nguyen GK . (2007) Solitary metastatic cancer to the thyroid: a report of five cases with fine-needle aspiration cytology. Cytojournal 4:5.CrossRefPubMedPubMedCentralGoogle Scholar
  48. 48.
    Wey SL, Chang KM (2015) Tumor-to-tumor metastasis: lung carcinoma metastasizing to thyroid neoplasms. Case Rep Pathol. 2015:153932.Google Scholar
  49. 49.
    Poon D, Toh HC, Sim CS. (2004) Two case reports of metastases from colon carcinoma to the thyroid. Ann Acad Med Singapore. 33(1):100–102.PubMedGoogle Scholar
  50. 50.
    Cheung WY, Brierley J, Mackay HJ. (2008) Treatment of rectal cancer metastases to the thyroid gland: report of two cases. Clin Colorectal Cancer. 7(4):280–282.CrossRefPubMedGoogle Scholar
  51. 51.
    Chen H, Nicol TL, Udelsman R. (1999b) Clinically significant, isolated metastatic disease to the thyroid gland. World J. Surg 23: 177–181.CrossRefPubMedGoogle Scholar
  52. 52.
    Lin JD, Weng HF, Ho YS (1998) Clinical and pathological characteristics of secondary thyroid cancer. Thyroid. 8(2):149–153.CrossRefPubMedGoogle Scholar
  53. 53.
    Leboulleux S, Baudin E, Young J et al (1999) Gastroenteropancreatic neuroendocrine tumor metastases to the thyroid gland: differential diagnosis with medullary thyroid carcinoma. European Journal of Endocrinology. 140: 187–191.CrossRefPubMedGoogle Scholar
  54. 54.
    Nakhjavani MK, Gharib H, Goellner JR, van Heerden JA. (1997c) Metastasis to the thyroid gland. A report of 43 cases. Cancer. 79(3):574–578.CrossRefPubMedGoogle Scholar
  55. 55.
    Michelow PM, Leiman G. (1995) Metastases to the thyroid gland: diagnosis by aspiration cytology. Diagn. Cytopathol. 13(3): 209–213.CrossRefPubMedGoogle Scholar
  56. 56.
    Sindoni A, Rizzo M, Tuccari G et al (2010) Thyroid metastases from renal cell carcinoma: review of the literature. The Scientific World Journal 10: 590–602.CrossRefPubMedPubMedCentralGoogle Scholar
  57. 57.
    Bishop JA, Sharma R, Westra WH. (2011) PAX8 immunostaining of anaplastic thyroid carcinoma: a reliable means of discerning thyroid origin for undifferentiated tumors of the head and neck. Hum Pathol 42:1873–1877.CrossRefPubMedGoogle Scholar
  58. 58.
    Bellevicine C, Vigliar E, Malapelle U et al (2015) Lung adenocarcinoma and its thyroid metastasis characterized on fine-needle aspirates by cytomorphology, immunocytochemistry, and next-generation sequencing. Diagn. Cytopathol. 43 (7): 585–589.CrossRefPubMedGoogle Scholar
  59. 59.
    Albany C, Jain A, Ulbright TM, Einhorn LH. (2011) Lung cancer, thyroid cancer or both: an unusual case presentation. J Thorac Dis. 3(4):271–273.PubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Patrizia Straccia
    • 1
  • Claudia Mosseri
    • 1
  • Chiara Brunelli
    • 1
  • Esther Diana Rossi
    • 1
  • Celestino Pio Lombardi
    • 2
  • Alfredo Pontecorvi
    • 3
  • Guido Fadda
    • 1
    Email author
  1. 1.Division of Anatomic Pathology and Histology Catholic University of Sacred HeartFoundation “Agostino Gemelli” University HospitalRomeItaly
  2. 2.Division of Endocrine Surgery, Catholic University of Sacred HeartFoundation “Agostino Gemelli” University HospitalRomeItaly
  3. 3.Division of Endocrinology, Catholic University of Sacred HeartFoundation “Agostino Gemelli” University HospitalRomeItaly

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