Splenomegaly as the First Manifestation of Thyroid Cancer Metastases

1997 ◽  
Vol 83 (4) ◽  
pp. 779-782 ◽  
Author(s):  
Rossella Paolini ◽  
Sandra Toffoli ◽  
Alessandro Poletti ◽  
Dario Casara ◽  
Paolo Moschino ◽  
...  

We report the case of a 65-year-old man who developed a symptomatic splenomegaly due to spleen metastasis from thyroid follicular carcinoma. In 1982, at the age of 53, the patient had undergone a thyroid lobectomy for a cold node, followed one year later by a second intervention for a microfollicular adenoma. He was subsequently administered thyroid suppressive therapy with no further follow-up. The diagnosis of spleen metastases from thyroid cancer was first suspected on the basis of history, high serum thyroglobulin (Tg) levels, and the presence of pulmonary 99Tc uptake. The patient underwent a splenectomy, during which vast infiltration involving the diaphragm, spleen, stomach, colon and pancreas, was found. Histological and immunohistochemical results showed that the spleen and diaphragm metastases derived from thyroid follicular carcinoma. Radioiodine uptake by the pulmonary metastases confirmed the thyroid source. Retrospective re-evaluation of the thyroid tissue removed in 1983 revealed a histological pattern consistent with follicular carcinoma, which could not be unequivocally attributed to the widely or minimally invasive form. To our knowledge this is the first report of splenomegaly as the first manifestation of thyroid cancer metastases. In this paper cases of splenomegaly due to metastatic spread are reviewed and the management of the present case is discussed.

2010 ◽  
Vol 54 (6) ◽  
pp. 550-554 ◽  
Author(s):  
André B. Zanella ◽  
Erika L. Souza Meyer ◽  
Letícia Balzan ◽  
Antônio C. Silva ◽  
Joíza Camargo ◽  
...  

OBJECTIVE: The aim of this study was to evaluate the accuracy of the measurement of thyroglobulin in washout needle aspiration biopsy (FNAB-Tg) to detect papillary thyroid cancer (PTC) metastases. SUBJECTS AND METHODS: Forty-three patients (51.4 ± 14.6 years) with PTC diagnosis and evidence of enlarged cervical lymph nodes (LN) were included. An ultrasound-guided fine-needle aspiration of suspicious LN was performed, for both cytological examination and measurement of FNAB-Tg. RESULTS: The median values of FNAB-Tg in patients with metastatic LN (n = 5) was 3,419 ng/mL (11.1-25,538), while patients without LN metastasis (n = 38) showed levels of 3.7 ng/mL (0.8-7.4). Considering a 10 ng/mL cutoff value for FNAB-Tg, the sensitivity and specificity was 100%. There were no differences on the median of FNAB-Tg measurements between those on (TSH 0.07 mUI/mL) or off levothyroxine (TSH 97.4 mUI/mL) therapy (3.3 vs. 3.8 ng/mL, respectively; P = 0.2). CONCLUSION: The results show that evaluation of FNAB-Tg in cervical LN is a valuable diagnostic tool for PTC metastases that can be used independent of the thyroid status.


HPB ◽  
2019 ◽  
Vol 21 ◽  
pp. S612
Author(s):  
J. Ligocka ◽  
W. Patkowski ◽  
M. Morawski ◽  
M. Krasnodębski ◽  
M. Grąt ◽  
...  

2011 ◽  
Vol 68 (10) ◽  
pp. 891-894
Author(s):  
Aleksandar Filipovic ◽  
Ljiljana Vuckovic ◽  
Milan Mijovic

Introduction. Although follicular thyroid carcinoma is a rare malignant tumor, up to 20% of the patients are threatened by potential complications resulting from infiltrating tumor growth into surrounding tissues. Case report. A 66- year-old female came to hospital with the presence of a growing thyroid nodule of the left lobe. Ultrasonic examination showed a 8 cm hypoechoic nodule in the left lobe. Thyroid scintigraphy showed a cold nodule. CT scan and tracheoscopy showed tracheal infiltration without tracheal obstruction. An extended total thyroidectomy was done, with the left jugular vein, strap muscles and tracheal 2 cm long circular resection. The pathologist confirmed invasive follicular thyroid cancer. After the surgery the patient was treated with radioiodine therapy and permanent TSH suppressive therapy. The patient was followed with measurements of the thyroid hormone and serum thyroglobulin level every six months, as well as the further tests (chest xray, ultrasound of the neck and a whole body scintigraphy) were done. After more than three years the patient had no evidence of the recurrent disease. Conclusion. Radical resection of the tracheal infiltrating thyroid cancer with circular tracheal resection and terminoterminal anastomosis followed by radioiodine therapy should be considered the treatment of choice.


2015 ◽  
Vol 40 (5) ◽  
pp. 442-445 ◽  
Author(s):  
Bin Liu ◽  
Summer L. Kaplan ◽  
Hua Yang ◽  
Ion Codreanu ◽  
Hongming Zhuang

Thyroid ◽  
1998 ◽  
Vol 8 (12) ◽  
pp. 1091-1100 ◽  
Author(s):  
MD. SAYEEDUL ALAM ◽  
KANJI KASAGI ◽  
TAKASHI MISAKI ◽  
SHINICHI MIYAMOTO ◽  
MASAHIRO IWATA ◽  
...  

2021 ◽  
Vol 10 (4) ◽  
pp. 50-59
Author(s):  
S. E. Titov ◽  
G. A Katanyan ◽  
T. L. Poloz ◽  
L. G. Izmaylova ◽  
О. А. Zentsova ◽  
...  

Introduction. The main method of preoperative diagnosis of thyroid tumors and the identification of possible metastasis is a cytological examination of smears obtained by fine-needle aspiration biopsy. However, the cytological material of the lymph nodes may not be adequate, and the detection of metastases faces a number of difficulties. In our recent study, we described a variant of the molecular classifier that allows the detection and typing of malignant thyroid tumors by analyzing several molecular markers in cytological preparations.The study objective was to assess the applicability of the developed method for the preoperative detection of metastases of papillary and medullary thyroid cancer in the lymph nodes of the neck lateral cellular tissue.Materials and methods. A total of 86 cytological samples were used, obtained from individual lymph nodes of 62 patients who had a diagnosis – thyroid cancer. Samples were analyzed by real-time polymerase chain reaction regarding the preselected set of molecular markers: the BRAF V600E mutation, the normalized concentration of HMGA2, FN1 and SERPINA1 mRNA, 5 miRNAs and the mitochondrial/nuclear DNA ratio. The decision tree-based classifier was used to discriminate between benign and malignant samples.Results. The previously described classifier, based on the analysis of the BRAF V600E mutation, the content of HMGA2 mRNA, 3 miRNAs and the mitochondrial/nuclear DNA ratio, revealed metastases of thyroid cancer with good specificity (98 %) but less sensitivity (83 %). Therefore, a new classifier was built, including three markers – HMGA2 and FN1 mRNA, and miRNA-375, which, with regard to the detection of metastases, showed good sensitivity – 93 % with a slight decrease in specificity (up to 96 %).Conclusion. Thus, we demonstrated the possibility of preoperative detection of thyroid cancer metastases in the lymph nodes of the neck lateral cellular tissue by analyzing several molecular markers in cytological material.


2010 ◽  
Vol 8 (11) ◽  
pp. 1277-1287 ◽  
Author(s):  
Stephanie L. Lee

Radioactive iodine (RAI) in the form of 131I has been used to treat thyroid cancer since 1946. RAI is used after thyroidectomy to ablate the residual normal thyroid remnant, as adjuvant therapy, and to treat thyroid cancer metastases. Although the benefits of using RAI in low-risk patients with thyroid cancer are debated, it is frequently used in most patients with thyroid cancer and is clearly associated with acute and long-term risks and side effects. Acute risks associated with RAI therapy include nausea and vomiting, ageusia (loss of taste), salivary gland swelling, and pain. Longer-term complications include recurrent sialoadenitis associated with xerostomia, mouth pain, dental caries, pulmonary fibrosis, nasolacrimal outflow obstruction, and second primary malignancies. This article summarizes the common complications of RAI and methods to prevent and manage these complications.


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