Annals of Surgical Oncology

, Volume 22, Issue 2, pp 460–466 | Cite as

Rare Metastases of Well-Differentiated Thyroid Cancers: A Systematic Review

  • Amin Madani
  • Yelda Jozaghi
  • Roger Tabah
  • Jacques How
  • Elliot MitmakerEmail author
Endocrine Tumors



A minority of metastatic well-differentiated thyroid cancer (WDTC) patients present with end-organ disease other than in the lung, bone or lymph nodes. These metastases tend to be overlooked because of their low incidence, and this results in delayed diagnosis. The purpose of this study was to perform a systematic review of the clinical and histologic features of unusual WDTC metastases.


A systematic literature search of bibliographic databases, reference lists of articles, and conference proceedings was performed up to 2013. Studies were included if they reported on adult patients with WDTC and pathology-proven metastases to end-organs other than lung, bone, or lymph nodes. A total of 238 studies were included in a qualitative analysis. Data is expressed as N (%) and median [interquartile range].


A total of 492 patients (median age, 62 years [50–70 years]) were identified in 197 case reports and 42 case series. There were 22 different end-organ metastatic sites documented with either papillary [255 (57 %)], follicular [172 (39 %)], or Hürthle-cell [18 (4 %)] histology. A total of 181 (41 %) patients presented with solitary metastasis and 54 (93 %) with elevated serum thyroglobulin. Positron emission tomography and whole-body radioactive iodine scans revealed hypermetabolic foci in 28 (97 %) and 50 (81 %) cases, respectively. Disease-free interval following the initial diagnosis of the primary thyroid cancer was highly variable, ranging from synchronous presentation [66 (33 %)] to metachronous disease after 516 months [mean 86 months (SD 90)].


WDTC can manifest with highly variable and unusual clinical features. Rare sites of metastases should be considered in the absence of the more common extra-cervical disease recurrence locations.


Thyroid Cancer Papillary Thyroid Cancer Follicular Thyroid Carcinoma Thyroid Cancer Cell Thyroid Lymphoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



There are no competing interests declared.

Supplementary material

10434_2014_4058_MOESM1_ESM.doc (546 kb)
Supplementary material 1 (DOC 546 kb)


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Copyright information

© Society of Surgical Oncology 2014

Authors and Affiliations

  • Amin Madani
    • 1
  • Yelda Jozaghi
    • 2
  • Roger Tabah
    • 1
  • Jacques How
    • 3
  • Elliot Mitmaker
    • 1
    Email author
  1. 1.Division of General SurgeryMcGill UniversityMontrealCanada
  2. 2.Faculty of MedicineMcGill UniversityMontrealCanada
  3. 3.Division of EndocrinologyMcGill UniversityMontrealCanada

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