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Solitary liver metastasis from Hürthle cell thyroid cancer: A Case Report and review of the literature

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Abstract

Metastasis to the liver from thyroid cancer is a rare event with a reported frequency of 0.5%. Metastatic liver involvement from differentiated thyroid cancer (DTC) is nearly always multiple or diffuse and usually found along with other distant metastases (lung, bone and brain). The authors describe a patient with a solitary liver metastasis from Hürthle cell thyroid cancer, which appeared during long-term follow-up. The lesion was diagnosed by progressive increase of thyroglobulin in the serum and imaged with I-131 whole body scan, ultrasonography, magnetic resonance imaging (MRI) and F-18 fluoro-deoxyglucose positron emission tomography (FDG-PET) scan. For patients with a Tg level above some arbitrary limit, the administration of a large dose (3.7–5.5 GBq; 100–150 mCi) of I-131, in order to obtain a highly sensitive Tx whole body scan (WBS), remains the best diagnostic strategy. However, on very rare occasions, physiological enteric radioactivity can hide possible abdominal lesions and further indepth studies, such as FDG-PET scans, are sometimes necessary.

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References

  1. Shah DH, Samuel AM. Metastasis to the liver in well-differentiated carcinoma of the thyroid. Thyroid 1996, 6: 607–11.

    Article  CAS  PubMed  Google Scholar 

  2. Tur GE, Asanuma T, Sato T, et al. Resection of metastatic thyroid carcinoma to the liver and kidney: report of a case. Surg Today 1994, 24: 844–8.

    Article  CAS  PubMed  Google Scholar 

  3. Graves WM, Zukerberg B, Walace K, Duncan D, Scheff A. Isolated liver metastases from follicular thyroid cancer. Clin Nucl Med 1996, 21: 147–8.

    Article  CAS  PubMed  Google Scholar 

  4. Ohwada S, Iino Y, Hosomura Y, et al. Solitary metastasis from papillary thyroid carcinoma in cirrhotic liver with hepatocellular carcinoma. Jpn J Clin Oncol 1993, 23: 309–12.

    CAS  PubMed  Google Scholar 

  5. Sabin LH, Wittekind CH. UICC: TNM classification of malignant tumors. 5th ed. New York: Wiley-Liss. 1997.

    Google Scholar 

  6. Brown AP, Greening WP, McCready VR, Shaw HJ, Harmer CL. Radioiodine treatment of metastatic thyroid carcinoma: the Royal Marsden Hospital experience. Br J Radiol 1984, 57: 323–7.

    Article  CAS  PubMed  Google Scholar 

  7. Sillphanar WM, Killock GH, Levitin MS. Thyroid carcinoma and death: a clinicopathological study of 193 autopsias. Cancer 1964, 17: 513–25.

    Article  Google Scholar 

  8. Heiz P, Moser H, Staub JJ. Thyroid cancer. A study of 573 tumors and 161 autopsy cases observed over a thyrty-year period. Cancer 1976, 37: 2329–37.

    Article  Google Scholar 

  9. Wood WJ, Singletary SE, Hickey RC. Current results of treatment for distant metastatic well-differentiated thyroid carcinoma. Arch Surg 1989, 124: 1374–7.

    Article  PubMed  Google Scholar 

  10. Mizukami Y, Michigishi T, Nonomura A, et al. Distant metastases in differentiated thyroid carcinoma: a clinical and pathologic study. Hum Pathol 1990, 21: 283–90.

    Article  CAS  PubMed  Google Scholar 

  11. Shapiro B, Rufini V, Jarwan A, et al. Artifacts, anatomical and physiological variants, and unrelated diseases that might cause false-positive whole-body 131-I scans in patients with thyroid cancer. Semin Nucl Med 2000, 30: 115–32.

    Article  CAS  PubMed  Google Scholar 

  12. Bolon HR, Fing-Bennett D, Stoffer SS. Technetium-99msestamibi uptake by recurrent Hürthle cell carcinoma of the thyroid. J Nucl Med 1992, 33: 1393–5.

    Google Scholar 

  13. Wang W, Macapinlac H, Larson SM, et al. [18F]-2-fluoro-2-deoxy-D-glucose positron emission tomography localizes residual thyroid cancer in patients with negative diagnostic 131I whole body scans and elevated serum thyroglobulin levels. J Clin Endocrinol Metab 1999, 84: 2291–302.

    Article  CAS  PubMed  Google Scholar 

  14. Plotkin M, Hautzel H, Krause BJ, et al. Implication of 2-18Fluor-2-deoxyglucose positron emission tomography in the follow-up of Hürthle cell thyroid cancer. Thyroid 2002, 12: 155–61.

    Article  PubMed  Google Scholar 

  15. Spencer CA, Lo Presti JS, Fatemi S, Nicoloff JT. Detection of residual and recurrent differentiated thyroid carcinoma by serum thyroglobulin measurement. Thyroid 1999, 9: 435–41.

    Article  CAS  PubMed  Google Scholar 

  16. Wang W, Larson SM, Fazzari M, et al. Prognostic value of [18F]fluorodeoxyglucose positron emission tomographic scanning in patients with thyroid cancer. J Clin Endocrinol Metab 2000, 85: 1107–13.

    CAS  PubMed  Google Scholar 

  17. Izzo F, Barnett CC Jr, Curley SA. Radiofrequency ablation of primary and metastatic malignant liver tumors. Adv Surg 2001, 35: 225–50.

    CAS  PubMed  Google Scholar 

  18. Guglielmi R, Pacella CM, Dottorini ME, et al. Severe thyrotoxicosis due to hyperfunctioning liver metastasis from follicular carcinoma: treatment with 131I and interstitial laser ablation. Thyroid 1999, 9: 173–7.

    Article  CAS  PubMed  Google Scholar 

  19. Pacini F, Lippi F, Formica N, et al. Therapeutic doses of iodine-131 reveal undiagnosed metastases in thyroid cancer patients with detectable serum thyroglobulin levels. J Nucl Med 1987, 28: 1888–91

    CAS  PubMed  Google Scholar 

  20. Schlumberger M, Mancusi F, Baudin E, Pacini F. I-131 Therapy for elevated thyroglobulin levels. Thyroid 1997, 7: 273–6

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Nuclear Medicine Department, Catholic University of the Sacred Heart, Largo A. Gemelli, 8, 00168, Roma, Italy

    Massimo Salvatori M.D., G. Perotti, V. Rufini, M. L. Maussier & L. Troncone

  2. Radiological Department, Catholic University of the Sacred Heart, Rome, Italy

    V. Summaria

  3. Division of Anatomic Pathology and Histology, Catholic University of the Sacred Heart, Rome, Italy

    G. Fadda

Authors
  1. Massimo Salvatori M.D.
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  2. G. Perotti
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  3. V. Rufini
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  4. M. L. Maussier
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  5. V. Summaria
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  6. G. Fadda
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  7. L. Troncone
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Correspondence to Massimo Salvatori M.D..

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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, 52–56 (2004). https://doi.org/10.1007/BF03350911

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  • DOI: https://doi.org/10.1007/BF03350911

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