scholarly journals Radioactive Iodine Therapy in Patients With Thyroid Carcinoma With Distant Metastases: A SEER-Based Study

2020 ◽  
Vol 27 (1) ◽  
pp. 107327482091466
Author(s):  
Chenyuan Li ◽  
Qi Wu ◽  
Shengrong Sun
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Pulmonary Metastasis ◽  
Radioactive Iodine ◽  
Follicular Carcinoma ◽  
Distant Metastases ◽  
Dominant Negative ◽  
Grade Group ◽  
Cancer Specific Survival ◽  
Poor Grade

Distant metastasis (DM) is the dominant negative prognosis for thyroid carcinoma. Radioactive iodine (RAI) therapy serves as an effective treatment for thyroid carcinoma. However, resistance to RAI occurs in patients with DMs. The present study aims to discriminate patients who may benefit from RAI. We extracted patients with thyroid cancer in the Surveillance, Epidemiology, and End Results program and analyzed thyroid cancer–specific survival after radiotherapy based on age and grade subgroups. A total of 1608 patients having DMs were eligible, including 521 (32.4%) cases with bone metastasis, 90 (5.6%) cases with brain metastasis, 158 (9.8%) cases with liver metastasis, 995 (61.9%) cases with lung metastasis, and 50 (3.1%) cases with other metastases. Advanced age, poor differentiation, follicular carcinoma, lymphatic metastasis, tumor size >10 mm, and extracapsular invasion are associated with pulmonary metastases. With respect to patients with DM, RAI therapy improved the survival in the age <45 years group and the well-/moderately differentiated group. For patients with pulmonary metastasis, RAI improved the survival in the higher grade group but did not have a strong effect in the better grade group. Our data indicate that the disparity of metastatic sites has different risk factors. Similarly, this finding indicates that RAI should be precisely applied to patients who undergo DM but are young and have well-/moderately differentiated tumors and may improve survival in pulmonary metastasis patients with poor grade tumors.

scholarly journals Atypical Presentation as Unilateral Renal and Soft Tissue Metastases from Follicular Carcinoma Thyroid

2012 ◽  
Vol 3 (3) ◽  
pp. 184-186
Author(s):  
S Kumar ◽  
Ambikavathy Mohan ◽  
Udaya Kumar
Keyword(s):  
Thyroid Cancer ◽  
Soft Tissue ◽  
Thyroid Carcinoma ◽  
Left Kidney ◽  
Follicular Carcinoma ◽  
Distant Metastases ◽  
Needle Aspiration ◽  
Atypical Presentation ◽  
Follicular Thyroid Cancer ◽  
Follicular Carcinoma Thyroid

ABSTRACT Thyroid carcinoma comprises 1% of all malignancies. Follicular thyroid carcinoma is the second most common cancer of thyroid. Vascular invasion and hematogenous metastases to bone, lungs, brain, skin and adrenal glands has a reported incidence of 11 to 25%. The initial presentation of the patient with distant metastases is rare. Well-differentiated thyroid cancers with renal secondaries are reported in limited number of cases so far. W e report a case of an asymptomatic female patient who presented to us with soft tissue metastases to scalp, left sc apular regio n an d left k idn ey. On furth er evalu atin g, ultrasound of the neck showed a solitary nodule of 2 × 1 cm in the left lobe of thyroid. Fine needle aspiration cytology (FNAC) of thyroid reported as follicular carcinoma. FNAC of scalp, scapular swelling, and left kidney lesion was reported as metastatic lesions from follicular thyroid cancer. The patient refused any surgical intervention and she received three cycles of chemotherapy and suppressive treatment with L-thyroxine. She is on regular follow-up with the stable disease till date. We present this case for its rarity of renal metastases from follicular thyroid cancer. How to cite this article Mohan A, Kumar S, Kumar U. Atypical Presentation as Unilateral Renal and Soft Tissue Metastases from Follicular Carcinoma Thyroid. Int J Head and Neck Surg 2012;3(3):184-186.

scholarly journals Concurrent Hip Pain and Skull Lump as the First Manifestations of a Silent Follicular Thyroid Carcinoma

Reports ◽  
2020 ◽  
Vol 3 (4) ◽  
pp. 27 ◽  
Author(s):  
Kunta Setiaji ◽  
Widya Surya Avanti ◽  
Hanggoro Tri Rinonce ◽  
Sumadi Lukman Anwar
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Follicular Thyroid Carcinoma ◽  
Femoral Fractures ◽  
Distant Metastases ◽  
Metastatic Lesion ◽  
Primary Cancer ◽  
Follicular Thyroid Cancer ◽  
Long Term Prognosis

Follicular thyroid carcinoma is a slowly growing cancer with a generally good long-term prognosis. Distant metastasis from follicular thyroid cancer usually occurs in the lung and bones following a long period after diagnosis and treatment for primary cancer. Occult skull metastasis as the first presentation at diagnosis from follicular thyroid cancer is relatively rare. A 51-year-old woman presented with intermittent pain in her right hip that was treated due to the intensely progressed pain, motor weakness, and difficulty walking. The patient was then referred due to swelling in the forehead. Further evaluation revealed that the frontal swelling and the pathological femoral fractures were manifestations of distant metastases from follicular thyroid cancer. In the presence of swelling in the skull, the metastatic lesion should be considered as a differential diagnosis from a silent primary cancer. This report will be beneficial for general practitioners, surgeons, and internists to recognize unusual distant metastatic manifestations from silent differentiated thyroid cancer.

scholarly journals Current controversies in the initial post-surgical radioactive iodine therapy for thyroid cancer: a narrative review

2014 ◽  
Vol 21 (6) ◽  
pp. R473-R484 ◽  
Author(s):  
Ralph Blumhardt ◽  
Ely A Wolin ◽  
William T Phillips ◽  
Umber A Salman ◽  
Ronald C Walker ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Radioactive Iodine ◽  
Distant Metastases ◽  
Operative Management ◽  
Low Risk ◽  
Nodal Disease ◽  
Dose Selection ◽  
Remnant Ablation ◽  
Risks And Benefits ◽  
Definition Of

Differentiated thyroid cancer (DTC) is the most common endocrine malignancy and the fifth most common cancer in women. DTC therapy requires a multimodal approach, including surgery, which is beyond the scope of this paper. However, for over 50 years, the post-operative management of the DTC post-thyroidectomy patient has included radioactive iodine (RAI) ablation and/or therapy. Before 2000, a typical RAI post-operative dose recommendation was 100 mCi for remnant ablation, 150 mCi for locoregional nodal disease, and 175–200 mCi for distant metastases. Recent recommendations have been made to decrease the dose in order to limit the perceived adverse effects of RAI including salivary gland dysfunction and inducing secondary primary malignancies. A significant controversy has thus arisen regarding the use of RAI, particularly in the management of the low-risk DTC patient. This debate includes the definition of the low-risk patient, RAI dose selection, and whether or not RAI is needed in all patients. To allow the reader to form an opinion regarding post-operative RAI therapy in DTC, a literature review of the risks and benefits is presented.

scholarly journals A False Positive I-131 Metastatic Survey Caused by Radioactive Iodine Uptake by a Benign Thymic Cyst

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Avneet K. Singh ◽  
Adina A. Bodolan ◽  
Matthew P. Gilbert
Keyword(s):  
Thyroid Cancer ◽  
False Positive ◽  
Differentiated Thyroid Cancer ◽  
Radioactive Iodine ◽  
Case Reports ◽  
Distant Metastases ◽  
The United States ◽  
Thymic Cyst ◽  
Pathological Findings ◽  
Thymic Cysts

Thyroid carcinoma is the most common endocrine malignancy in the United States with increasing incidence and diagnosis but stable mortality. Differentiated thyroid cancer rarely presents with distant metastases and is associated with a low risk of morbidity and mortality. Despite this, current protocols recommend remnant ablation with radioactive iodine and evaluation for local and distant metastasis in some patients with higher risk disease. There are several case reports of false positive results of metastatic surveys that are either normal physiologic variants or other pathological findings. Most false positive findings are associated with tissue that has physiologic increased uptake of I-131, such as breast tissue or lung tissue; pathological findings such as thymic cysts are also known to have increased uptake. Our case describes a rare finding of a thymic cyst found on a false positive I-131 metastatic survey. The patient was taken for surgical excision and the final pathology was a benign thymic cyst. Given that pulmonary metastases of differentiated thyroid cancer are rare, thymic cysts, though also rare, must be part of the differential diagnosis for false positive findings on an I-131 survey.

scholarly journals Radioactive iodine in the treatment of medullary thyroid carcinoma: a controlled multicenter study

2013 ◽  
Vol 168 (5) ◽  
pp. 779-786 ◽  
Author(s):  
J A A Meijer ◽  
L E H Bakker ◽  
G D Valk ◽  
W W de Herder ◽  
J H W de Wilt ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Multicenter Study ◽  
Radioactive Iodine ◽  
Disease Free Survival ◽  
Distant Metastases ◽  
Medullary Thyroid ◽  
Clinical Appearance ◽  
Significant Difference

ObjectiveRadioactive iodine (RAI) therapy in medullary thyroid carcinoma (MTC) is applied in some centers, based on the assumption that cross-irradiation from thyroid follicular cells may be beneficial. However, no systematic studies on the effect of RAI treatment in MTC have been performed. The aim of this study was to analyze the effect of RAI treatment on survival in MTC patients.DesignRetrospective multicenter study in eight University Medical Centers in The Netherlands.MethodsTwo hundred and ninety three MTC patients without distant metastases who had undergone a total thyroidectomy were included between 1980 and 2007. Patients were stratified by clinical appearance, hereditary stage, screening status, and localization. All patients underwent regular surgical treatment with additional RAI treatment in 61 patients. Main outcome measures were disease-free survival (DFS) and disease-specific survival (DSS). Cure was defined as biochemical and radiological absence of disease.ResultsIn multivariate analysis, stratification according to clinical appearance (P=0.72), hereditary stage (P=0.96), localization (P=0.69), and screening status (P=0.31) revealed no significant effects of RAI treatment on DFS. Multivariate analysis showed no significant difference in DSS for the two groups stratified according to clinical appearance (P=0.14). Owing to limited number of events, multivariate analysis was not possible for DSS in the other groups of stratification.ConclusionsBased on the results of the present analysis, we conclude that RAI has no place in the treatment of MTC.

Metastatic Thyroid Carcinoma Presenting as Distal Spinal Cord Compression

1988 ◽  
Vol 97 (4) ◽  
pp. 393-396 ◽  
Author(s):  
Steven I. Goldstein ◽  
David Kaufman ◽  
Andrea D. Abati
Keyword(s):  
Spinal Cord ◽  
Thyroid Carcinoma ◽  
Spinal Cord Compression ◽  
Radioactive Iodine ◽  
Follicular Carcinoma ◽  
Cord Compression ◽  
Radioactive Iodine Therapy ◽  
Decompressive Laminectomy ◽  
Vertebral Bodies ◽  
Bony Metastases

The prognosis of metastatic thyroid carcinoma is dependent on the age of the patient, the histologic characteristics of the neoplasm, and the site of metastasis. A more favorable prognosis is found in patients less than 40 years old with follicular carcinoma and without any bony metastases. Metastatic thyroid carcinoma presenting as distal spinal cord compression is extremely rare. We report one such case and review the literature. As reported in the literature, the combination of decompressive laminectomy followed by total thyroidectomy and radioactive iodine therapy has proved to be effective in the treatment of patients with thyroid carcinoma metastatic to the distal vertebral bodies.

scholarly journals A case of papillary thyroid cancer with soft tissue metastasis

2018 ◽  
Vol 5 (10) ◽  
pp. 3425 ◽  
Author(s):  
Jayan Stephen ◽  
Mebin B. Thomas ◽  
Mathew B. Thomas
Keyword(s):  
Thyroid Cancer ◽  
Soft Tissue ◽  
Thyroid Carcinoma ◽  
Papillary Thyroid Cancer ◽  
Distant Metastases ◽  
Differentiated Thyroid Carcinoma ◽  
Metastatic Tumour ◽  
Papillary Thyroid ◽  
Soft Tissue Metastasis ◽  
Regional Lymph Nodes

Papillary thyroid cancer is the most common thyroid malignancy, and although metastatic spread is typically confined to regional lymph nodes, there are rare documented cases of distant spread of disease. Distant metastases of differentiated thyroid cancer are unusual; lung and bones are the most frequently affected sites. Soft tissue metastases are extremely rare. Here we present an unusual case of soft tissue metastasis of papillary thyroid cancer to skeletal muscle. Soft tissue metastasis is rarely seen in differentiated thyroid carcinoma. Differentiated thyroid carcinoma, although generally clinically indolent, may occasionally develop distant metastases and even manifest itself as a metastatic tumour.

scholarly journals Follicular thyroid carcinoma with NRAS Q61K and GNAS R201H mutations that had a good 131I treatment response

2016 ◽  
Vol 2016 ◽  
Author(s):  
Jin-Ying Lu ◽  
Po-Ju Hung ◽  
Pei-Lung Chen ◽  
Ruoh-Fang Yen ◽  
Kuan-Ting Kuo ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Treatment Response ◽  
Radioactive Iodine ◽  
Follicular Thyroid Carcinoma ◽  
Follicular Carcinoma ◽  
List Type ◽  
131I Treatment ◽  
Autonomously Functioning Thyroid Nodules ◽  
Iodine Treatment ◽  
Gs Alpha

Summary We report a case of follicular thyroid carcinoma with concomitant NRAS p.Q61K and GNAS p.R201H mutations, which manifested as a 13.5 cm thyroid mass with lung, humerus and T9 spine metastases, and exhibited good response to radioactive iodine treatment. Learning points GNAS p.R201H somatic mutation is an activating or gain-of-function mutation resulting in constitutively activated Gs-alpha protein and downstream cAMP cascade, independent of TSH signaling, causing autonomously functioning thyroid nodules. NRAS p.Q61K mutations with GNAS p.R201H mutations are known for a good radioactive iodine treatment response. Further exploration of the GNAS-activating pathway may provide therapeutic insights into the treatment of metastatic follicular carcinoma.

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