scholarly journals Thyroid crisis caused by metastatic thyroid cancer: an autopsy case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kai Takedani ◽  
Masakazu Notsu ◽  
Naoko Adachi ◽  
Sayuri Tanaka ◽  
Masahiro Yamamoto ◽  
...  

Abstract Background Thyroid crisis is a life-threatening condition in thyrotoxic patients. Although differentiated thyroid cancer is one of the causes of hyperthyroidism, reports on thyroid crisis caused by thyroid cancer are quite limited. Here, we describe a case of thyroid crisis caused by metastatic thyroid cancer. Case presentation A 91-year-old woman was admitted to our hospital because of loss of appetite. Two years prior to this hospitalization, she presented with subclinical thyrotoxicosis and was diagnosed with histologically unidentified thyroid cancer with multiple metastases, and she refused aggressive medical interventions. On admission, she exhibited extreme thyrotoxicosis, and the presence of fever, severe tachycardia, impaired consciousness, and heart failure revealed the presence of thyroid crisis. All thyroid autoantibodies were negative. Multidisciplinary conservative treatment was initiated; however, she died on the fifth day after admission. Autopsy revealed the presence of primary anaplastic thyroid carcinoma and multiple metastatic foci arising from follicular thyroid carcinoma. Both primary and metastatic follicular thyroid carcinoma likely induced thyrotoxicosis, which could have been exacerbated by anaplastic thyroid carcinoma. Conclusions Even though the trigger of thyroid crisis in this patient is not clear, the aggravated progression of her clinical course suggests that careful monitoring of thyroid hormones and appropriate intervention are essential for patients with thyroid cancer.

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Weiying Lim ◽  
Dawn Shaoting Lim ◽  
Chiaw Ling Chng ◽  
Adoree Yiying Lim

We present 2 patients with pituitary metastases from thyroid carcinoma—the first from anaplastic thyroid carcinoma and the second from follicular thyroid carcinoma. The first patient, a 50-year-old lady, presented with 2-week history of hoarseness of voice, dysphagia, dyspnoea, and neck swelling. Imaging revealed metastatic thyroid cancer to lymph nodes and bone. Histology from surgery confirmed anaplastic thyroid cancer. She was found to have pituitary metastases postoperatively when she presented with nonvertiginous dizziness. She subsequently underwent radiotherapy and radioiodine treatment but passed away from complications. The second patient, a 65-year-old lady, presented with loss of appetite and weight with increased goitre size and dyspnoea. Surgery was performed in view of compressive symptoms and histology confirmed follicular thyroid carcinoma. Imaging revealed metastases to bone, lung, and pituitary. She also had panhypopituitarism with hyperprolactinemia and diabetes insipidus. She received radioiodine therapy but eventually passed away from complications.


2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Enrico Maria Amadei ◽  
Laura Benedettini ◽  
Ottavio Piccin

Several are the causes of cervical masses and among them a spontaneous hemorrhage presents a rare and life-threatening condition. Sometimes hemorrhage develops from a previous silent neck lesion as in the case of an anaplastic thyroid carcinoma associated with bleeding. We present two cases: a 70-year-old woman suffering from enlarging cervical mass causing respiratory distress because of upper airway compression due to a spontaneous rupture of the superior thyroid artery and a 74-year-old woman who drew our attention because of a progressively worsening dyspnea due to a large medial cervical mass with rapid onset. We removed it surgically, finding out an anaplastic thyroid carcinoma that is associated with internal bleeding. We discuss our management of these rare and life-threatening conditions, recalling that the patency of upper airway should always be the prerogative in every emergency. Besides, we make a review of the recent literature.


2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Ethan Vargo ◽  
Bryson Cook ◽  
Jason Lane ◽  
Eric Speakman ◽  
Neel Parekh

Metastasis to the penis is an extremely rare entity. Malignant priapism is defined as a persistent, nonsexual erection that is refractory to pharmacologic treatment, corporal aspiration, and surgical shunts. Furthermore, it is typically a hallmark of an advanced cancer that has metastasized, most commonly from regional organs like the prostate or bladder. We report an unusual case of malignant priapism in the setting of metastatic follicular thyroid carcinoma. To date, this is the second reported case of penile metastasis due to thyroid carcinoma and the first incidence of priapism secondary to follicular thyroid carcinoma metastasis.


2019 ◽  
Vol 20 (9) ◽  
pp. 2212 ◽  
Author(s):  
Magdalena Rudzińska ◽  
Małgorzata Grzanka ◽  
Anna Stachurska ◽  
Michał Mikula ◽  
Katarzyna Paczkowska ◽  
...  

The prospero homeobox 1 (PROX1) transcription factor is a product of one of the lymphangiogenesis master genes. It has also been suggested to play a role in carcinogenesis, although its precise role in tumour development and metastasis remains unclear. The aim of this study was to gain more knowledge on the PROX1 function in thyroid tumorigenesis. Follicular thyroid cancer-derived cells—CGTH-W-1—were transfected with PROX1-siRNA (small interfering RNA) and their proliferation, cell cycle, apoptosis and motility were then analysed. The transcriptional signature of PROX1 depletion was determined using RNA-Sequencing (RNA-Seq) and the expression of relevant genes was further validated using reverse transcriptase quantitative PCR (RT-qPCR), Western blot and immunocytochemistry. PROX1 depletion resulted in a decreased cell motility, with both migratory and invasive potential being significantly reduced. The cell morphology was also affected, while the other studied cancer-related cell characteristics were not significantly altered. RNA-seq analysis revealed significant changes in the expression of transcripts encoding genes involved in both motility and cytoskeleton organization. Our transcriptional analysis of PROX1-depleted follicular thyroid carcinoma cells followed by functional and phenotypical analyses provide, for the first time, evidence that PROX1 plays an important role in the metastasis of thyroid cancer cells by regulating genes involved in focal adhesion and cytoskeleton organization in tumour cells.


Reports ◽  
2020 ◽  
Vol 3 (4) ◽  
pp. 27 ◽  
Author(s):  
Kunta Setiaji ◽  
Widya Surya Avanti ◽  
Hanggoro Tri Rinonce ◽  
Sumadi Lukman Anwar

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.


2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Ichiro Abe ◽  
Satoko Karasaki ◽  
Yayoi Matsuda ◽  
Shohei Sakamoto ◽  
Torahiko Nakashima ◽  
...  

Anaplastic thyroid carcinoma (ATC) although rare is the most lethal form of thyroid cancer. The mortality rate for ATC is very high, with a median survival time of only 5 months; the survival rate at 1 year after diagnosis is <20%. Management of ATC is extremely difficult and rife with uncertainties. Herein, we describe a 75-year-old woman who presented with ATC and was successfully treated using concomitant treatment with docetaxel and high-dose radiotherapy. This case appears to be the first to have been reported in the literature involving complete remission of ATC confirmed by autopsy, suggesting the therapeutic potential of this combination.


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.


2021 ◽  
Vol 63 (9) ◽  
pp. 6-9
Author(s):  
Xuan Hau Nguyen ◽  
◽  
Thi Phuong Anh Nguyen ◽  
Van Quang Le ◽  
◽  
...  

This study aims to evaluate the clinicopathological and metastasis status of follicular thyroid cancer at K Hospital. We conducted a retrospective combined with prospective cohort study of 48 follicular thyroid carcinoma patients treated by surgery at K hospital from January 2016 to July 2020. The mean age was 44±16.1 and the female/male ratio was 4.3/1. Most patients presented with an asymptomatic and had a unilateral tumor with mean diameter was 21.7±12 mm. 72.9% of tumors were classified as TIRADS 4 on ultrasound, and FNA did not play a big role in the diagnosis of follicular thyroid carcinoma with undetermined significance result in 48.9% of cases. Distant metastasis in 18.8%, the most common metastatic sites were bone, followed by the lungs. The overall rate of nodal metastasis was 31.3%. Cancer in both thyroid lobes had significantly associated with nodal metastasis (p<0.05)


Author(s):  
Tsung-Chun Huang ◽  
Yu-Kai Cheng ◽  
Tsung-Wei Chen ◽  
Yung-Chang Hsu ◽  
En-Wei Liu ◽  
...  

Summary Thyroid cancer with cranial metastasis in a pregnant woman is very rare. In the literature, most cases are diagnosed early from neurogenic signs or symptomatic thyroid gland. Pregnancy also contributes to a hesitation toward early surgical and medical treatments. We reported a scalp tumor in a physically healthy 37-year-old pregnant female with a follicular thyroid carcinoma (FTC) with lung, bone and cranial metastasis in initial presentation. Silent neurogenic and physical examinations make an early diagnosis very challenging. Resection of scalp and intracranial tumor, a thyroidectomy, post-operative radioactive iodine therapy and tyrosine kinase inhibitors were employed as treatment. The scalp tumor was confirmed as a metastatic follicular thyroid carcinoma via positive immunoreactivity for thyroglobulin and thyroid transcription factor 1 in tumor cells. Blood examination revealed an elevated thyroglobulin level (>5335 ng/mL). The patient was discharged without any neurological deficit. An asymptomatic scalp tumor in a pregnant woman with a normal thyroid disease history needs differential diagnosis from intracranial origin. Rapid progression and an elevated thyroglobulin level are the indicators that further image study is needed. Aggressive surgical excision of resectable thyroid gland and metastatic tumor are essential for a longer survival rate. There is nothing to indicate that a post-partum operation will worsen prognosis. Learning points: Follicular thyroid cancer with cranial metastasis in initial presentation can be asymptomatic. Follicular thyroid cancer with cranial metastasis in a pregnant woman can be treated after delivery. Rapid enlargement of scalp tumor is indicated for further image study even in a patient without any neurological deficit.


Sign in / Sign up

Export Citation Format

Share Document