scholarly journals DISTANT METASTASIS TO THE THYROID GLAND: CLINICAL REVIEW

2020 ◽  
Vol 4 (14) ◽  
pp. 105-113
Author(s):  
R. Tkachenko ◽  
O. Kuryk ◽  
A. Golovko ◽  
O. Rudnytska
Keyword(s):  
Renal Cell Carcinoma ◽  
Thyroid Gland ◽  
Patient Management ◽  
Thyroid Nodules ◽  
Primary Site ◽  
Primary Cancer ◽  
Autopsy Series ◽  
History Of ◽  
Metastasis To The Thyroid

Background. Metastasis to the thyroid from non-thyroid sites is an uncommon clinical presentation in oncology practice. Renal cell carcinoma is most common primary cancer, followed by breast cancer metastases, small cell lung carcinoma, colorectal cancer, malignant melanoma, malignancies of the gastrointestinal cancer. However, given that thyroid nodules are most common in women, and women with a history of urogenital malignancy are at higher risk of developing thyroid cancer, the possibility of metastatic thyroid cancer must be considered while evaluating a thyroid lump. Aim: to investigate patient management while finding distant metastases to the thyroid and identification of the most common complications. Material and methods. Identified reports of patients with thyroid metastasis were analyzed in the current literature review. Both clinical and autopsy series were included. Results. Metastases to the thyroid gland may be discovered at the time of diagnosis of the primary cancer, after preoperative investigation or due to histological examination of an operative specimen. In autopsy series, the most common primary site of metastatic thyroid tumors is lung cancer. In a clinical setting, renal cell carcinoma is the most common. Otherwise, when patients present with isolated metastases during follow-up of indolent disease, surgery might provide central neck control and even long-term cure. Prognosis may also vary according to the morphological features of primary cancer, time interval between initial diagnosis and metastasis and presence of extrathyroid invasion. Conclusions. Although the thyroid gland is highly vascularized, metastasis of malignant tumors to the thyroid is relatively rare and detection of metastasis shows a low frequency. A past history of malignant neoplasm should raise the index of suspicious of metastatic disease in patients with thyroid nodules with or without cervical lymphadenopathy. In such patients communication among clinicians treating the thyroid and the primary tumor is essential, as there are differences in treatment protocols and prognosis when compared to primary thyroid cancers. The setting is complex, and decisions must be made considering the localization of primary site, features of the primary tumor and comorbidities.  Careful balancing of these factors influences effective patient management and long-term survival.

scholarly journals 18F-PET/CT imaging of metastasis to the thyroid gland: Imaging findings and effect on patient management

2017 ◽  
Vol 7 (2) ◽  
pp. 7 ◽  
Author(s):  
Giovanni G. Millare ◽  
Michael Kwon ◽  
Beth S. Edeiken-Monroe ◽  
J. Matthew Debnam
Keyword(s):  
Thyroid Gland ◽  
Patient Management ◽  
Standardized Uptake Value ◽  
Inclusion Criteria ◽  
Disease Extent ◽  
Thyroid Mass ◽  
Pet Ct ◽  
History Of ◽  
The Impact ◽  
Metastasis To The Thyroid

Purpose: While metastasis to the thyroid from a primary cancer remote to the thyroid is uncommon, current imaging techniqueshave improved detection of these intrathyroid metastases. The purpose of this study was to evaluate the 18F-PET/CT appearanceof intrathyroid metastases and assess the impact of detection on patient management.Methods: The 18F-PET/CT appearance of intrathyroid metastasis, including standardized uptake value (SUV), disease extent,and the effect on patient management following diagnosis were retrospectively reviewed. Inclusion criteria included 18F-PET/CTimaging and diagnosis of the intrathyroid metastasis matching the remote primary tumor.Results: Intrathyroid metastasis were detected in 24 patients. The intrathyroid metastases presented on 18F-PET/CT as focalnodular uptake (n = 21), multiple nodular uptake (n = 2), or diffuse uptake/infiltration of the thyroid gland (n = 1). The SUVranged between 3.9 and 42 (median 12.5 ± 7.5); in 2 patients, the FDG-avidity was minimal. On 18F-PET/CT, distant metastaseswere present outside the neck (n = 18), or limited to the neck (n = 6). In 2 of these 6 patients, the thyroid was the only site ofmetastatic disease. Due to the metastatic disease, the therapy was changed in 23 of 24 patients; 1 patient was lost to follow-up.Conclusion: In any patient with a previous or current history of an extrathyroid malignancy, an 18FDG-avid thyroid mass ordiffuse infiltration of the thyroid on 18F-PET/CT should be considered a potential intrathyoid metastasis until proven otherwise.Knowledge of an intrathyroid metastasis may impact patient management, especially if the thyroid or neck are the only sites ofmetastatic disease.

scholarly journals Thyroid Metastasis of Renal Cell Carcinoma

2011 ◽  
Vol 3 (2) ◽  
pp. 93-95 ◽  
Author(s):  
Bulent Citgez ◽  
Mehmet Uludag ◽  
Gurkan Yetkin ◽  
Esin Kabul Gurbulak ◽  
Banu Yılmaz Ozguven ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Thyroid Gland ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Previous History ◽  
Metastatic Tumor ◽  
Thyroid Metastasis ◽  
Thyroid Mass ◽  
History Of ◽  
Recurrent Malignancy

ABSTRACT Metastases to the thyroid gland are rare. We report the case of a 50-year-old man with an isolated thyroid metastasis from renal cell carcinoma (RCC), 3 years after radical nephrectomy for the primary disease. Although uncommon, if a patient with a previous history of malignancy has a new thyroid mass, it should be considered metastatic tumor of recurrent malignancy until proved otherwise.

LONG-TERM OUTCOMES OF RADIOIODINE THERAPY FOR JUVENILE GRAVES DISEASE WITH EMPHASIS ON SUBSEQUENTLY DETECTED THYROID NODULES: A SINGLE INSTITUTION EXPERIENCE FROM JAPAN

2020 ◽  
Vol 26 (7) ◽  
pp. 729-737 ◽  
Author(s):  
Tetsuya Mizokami ◽  
Katsuhiko Hamada ◽  
Tetsushi Maruta ◽  
Kiichiro Higashi ◽  
Junichi Tajiri
Keyword(s):  
Thyroid Gland ◽  
Thyroid Nodules ◽  
Radioiodine Therapy ◽  
Antithyroid Drug ◽  
Overt Hypothyroidism ◽  
Graves Disease ◽  
Outpatient Basis ◽  
Long Term Outcomes

Objective: To investigate the long-term outcomes of radioiodine therapy (RIT) for juvenile Graves disease (GD) and the ultrasonographic changes of the thyroid gland. Methods: All of 117 juvenile patients (25 males and 92 females, aged 10 to 18 [median 16] years) who had undergone RIT for GD at our clinic between 1999 and 2018 were retrospectively reviewed. Each RIT session was delivered on an outpatient basis. The maximum 131I dose per treatment was 13.0 mCi, and the total 131I dose per patient was 3.6 to 29.8 mCi (median, 13.0 mCi). 131I administration was performed once in 89 patients, twice in 26, and three times in 2 patients. Ultrasonography of the thyroid gland was regularly performed after RIT. The duration of follow-up after the initial RIT ranged from 4 to 226 (median 95) months. Results: At the latest follow-up more than 12 months after RIT (n = 111), the patients' thyroid functions were overt hypothyroidism (91%), subclinical hypothyroidism (2%), normal (5%), or subclinical hyperthyroidism (2%). New thyroid nodules were detected in 9 patients, 4 to 17 years after initial RIT. Patients with newly detected thyroid nodules underwent RIT with lower doses of 131I and had larger residual thyroid volumes than those without nodules. None of the patients were diagnosed with thyroid cancer or other malignancies during the follow-up period. Conclusion: Over a median follow-up period of 95 months (range, 4 to 226 months), RIT was found to be effective and safe in juvenile GD. However, cumulative evidence from further studies is required to confirm the long-term safety of RIT for juvenile GD. Abbreviations: ATD = antithyroid drug; GD = Graves disease; KI = potassium iodide; LT4 = levothyroxine; MMI = methimazole; PTU = propylthiouracil; RAIU = radio-active iodine uptake; RIT = radioiodine therapy; 99mTc = technetium-99m; TSH = thyrotropin

scholarly journals Malignant solitary fibrous tumor of the thyroid: a case-report and review of the literature

2014 ◽  
Vol 58 (4) ◽  
pp. 402-406 ◽  
Author(s):  
Wellington Alves Filho ◽  
Renata Regina da Graça Lorencetti Mahmoud ◽  
Daniel Marin Ramos ◽  
Vergilius José Furtado de Araujo-Filho ◽  
Patricia Picciarelli de Lima ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Solitary Fibrous Tumor ◽  
Spindle Cell ◽  
Spindle Cell Neoplasm ◽  
Cellular Atypia ◽  
Long Term Follow Up ◽  
History Of ◽  
Fibrous Tumor

Solitary fibrous tumor (SFT) is an uncommon spindle-cell neoplasm that most often involves the pleura, rarely occurring in extra-thoracic locations. Twenty-six cases of SFT arising in the thyroid gland have been described. We report a case of a 60-year-old woman presenting an 8-month history of enlargement of the neck associated with dysphagia. The patient underwent a right hemithyroidectomy and SFT of the thyroid was diagnosed. Immunohistochemistry showed positivity for CD34 marker, and the high number of mitoses and the presence of cellular atypia suggested that the tumor was malignant. To our knowledge, this is the second case of malignant SFT of the thyroid gland ever reported. Due to the rarity of these tumors, the indication of adjuvant therapy and prognosis are uncertain. Long-term follow-up after surgical resection seems to be advisable.

scholarly journals SUN-479 Metastatic Renal Cell Carcinoma (RCC) to the Thyroid: Case Report and Clinical Lesson

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Sreedevi Singidi Reddy ◽  
Nisha Reddy
Keyword(s):  
Renal Cell Carcinoma ◽  
Thyroid Gland ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Renal Mass ◽  
Thyroid Nodules ◽  
Clear Cell ◽  
Renal Tumors ◽  
Clinical Series ◽  
Thyroid Metastases

Abstract Background: Metastatic neoplasms to the thyroid gland are rare and have been observed more in autopsy series than in clinical series. Case: A 71-year old woman presented for thyroid nodule evaluation which was incidentally noted on CT/PET scan. She was diagnosed with renal cell carcinoma (RCC) stage IV (6.4 cm, left nephrectomy) 4 months prior. She had right hemi-thyroidectomy 30 years prior for a benign nodule. She was clinically and biochemically euthyroid with dysphagia and hoarseness in her voice. Thyroid u/s revealed multiple nodules in the left lobe with a dominant 3.6 x 2.9 x 3.6 cm solid, heterogeneous nodule with grade 3 hypervascularity. History positive for 1 cm right renal mass and multiple pulmonary nodules increasing in size thought to be consistent with metastases. The FNA of the dominant nodule was indeterminate, Bethesda III (AUS), GSC suspicious (Affirma, 50% ROM) with negative malignancy classifiers. Patient underwent completion thyroidectomy, and surgical path was consistent multifocal clear cell renal cell carcinoma (CRCC) with the largest focus of 3 cm based on clear cell features and strong positivity for stains: CK OSCAR, RCC, PAX-8 & CD-10. Patient is currently on Pazopanib post thyroid surgery for 18 months, and is stable with no further increase in the size of lung nodules or right renal mass and negative serial PET scans. Clinical lesson: CRCC represents 3-4% of all adult malignancies and 85% of all primary renal tumors. In clinical series, CRCC is the most frequent source of thyroid metastases and represents 12-34% of all secondary thyroid tumors. About 17% of patients with CRCC have metastatic disease at diagnosis. Metastases can be synchronous or metachronous to the primary tumor. Latency from nephrectomy to diagnosis of thyroid mets varies from 2 months-21.9 years. Metastases can be solitary (more common), multiple or diffuse. Radiological findings typically reveal hypoechoic and vascularized mass on ultrasound and cold on thyroid scan. Metastases to thyroid can pose diagnostic problem and be a source of confusion in cytology interpretation. Metastatic CRCC can simulate morphologically primary thyroid neoplasm such as Hurthle cell neoplasm or thyroid carcinomas with clear cell changes. Metastatic carcinoma within the thyroid gland is negative for thyroglobulin, TTF-1, calcitonin unlike primary thyroid cancer. CRCC is usually positive for periodic acid-Schiff and Oil red O, vimentin, and CD10. The mean survival in patients with CRCC who had thyroidectomy alone or with adjuvant treatment was 3 years. Conclusion: Thyroid metastases should be considered in patients with thyroid nodules and positive history of RCC. The preoperative distinction between primary and secondary tumors is difficult. Immunohistochemistry is a useful method for the evaluation of patients with suspected thyroid nodules.

scholarly journals Renal Cell Carcinoma Metastatic to Thyroid Gland, Presenting Like Anaplastic Carcinoma of Thyroid

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Khalid Riaz ◽  
Mutahir A. Tunio ◽  
Mushabbab AlAsiri ◽  
Asim Ali Elbagir Mohammad ◽  
Muhammad Mohsin Fareed
Keyword(s):  
Renal Cell Carcinoma ◽  
Thyroid Gland ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Past History ◽  
Abdominal Mass ◽  
Anaplastic Thyroid Carcinoma ◽  
Anaplastic Carcinoma ◽  
Rare Presentation ◽  
History Of

Background.Renal cell carcinoma (RCC) has unpredictable and diverse behavior. The classic triad of hematuria, loin pain, and abdominal mass is uncommon. At time of diagnosis, 25%–30% of patients are found to have metastases. Bones, lungs, liver, and brain are the frequent sites of metastases. RCC with metastasis to the head and neck region and thyroid gland is the rarest manifestation and anaplastic carcinoma behaving metastatic thyroid mass is an extremely rare presentation of RCC.Case Presentation.A 56-year-old Saudi man with past history of right radical nephrectomy 5 years back presented with 3 months history of rapid increasing neck mass with dysphagia, presenting like anaplastic thyroid carcinoma. Tru-cut biopsy turned out to be metastatic renal cell carcinoma. Patient was treated with radiation therapy 30 Gy in 10 fractions to mass. Patient died 4 months after the discovery of anaplastic thyroid looking metastasis.Conclusion.Rapidly progressing thyroid metastases secondary to RCC are rare and found often unresectable which are not amenable to surgery. Palliative radiotherapy can be considered for such patients.

A case of renal cell carcinoma with metastasis to the thyroid gland and concomitant early gastric cancer

Surgery Today ◽  
1993 ◽  
Vol 23 (2) ◽  
pp. 153-158 ◽  
Author(s):  
Saburo Murakami ◽  
Shigeru Yashuda ◽  
Takaya Nakamura ◽  
Yoshio Mishima ◽  
Hazuki Iida ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Renal Cell Carcinoma ◽  
Thyroid Gland ◽  
Early Gastric Cancer ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Metastasis To The Thyroid

Atherosclerosis in Chronic Renal Failure: A Historical Perspective

1983 ◽  
Vol 28 (3) ◽  
pp. 270-275 ◽  
Author(s):  
A. Nicholls
Keyword(s):  
Renal Failure ◽  
Renal Transplantation ◽  
Chronic Renal Failure ◽  
Natural History ◽  
Normal Population ◽  
Rational Approach ◽  
Autopsy Series ◽  
History Of ◽  
Per Se

It is commonly believed that atherogenesis is accelerated in patients with chronic renal failure during treatment by long-term dialysis or renal transplantation. However, several recent studies have failed to confirm this concept, despite the fact that overall atherosclerotic deaths in these patients are much higher than in the normal population. The natural history of atherogenesis in renal failure becomes much clearer if one analyses autopsy series of the pre-dialysis era. It is apparent from such studies that atheroma is frequent in renal failure before the development of terminal uraemia and that hypertension emerges as the major risk factor. Subsequent atherosclerotic deaths during long-term dialysis or renal transplantation may reflect progression of previously acquired atheroma, but do not per se indicate that atherogenesis has been accelerated after the commencement of renal replacement therapy. A proper appreciation of the natural history of atheroma in renal failure may permit a more rational approach to therapeutic intervention.

scholarly journals Thyroid Gland Metastasis from Cancer of the Uterine Cervix: An Extremely Rare Case Report

2016 ◽  
Vol 59 (3) ◽  
pp. 97-99
Author(s):  
Suleyman Utku Celik ◽  
Dilara Besli ◽  
Serpil Dizbay Sak ◽  
Volkan Genc
Keyword(s):  
Thyroid Gland ◽  
Uterine Cervix ◽  
Thyroid Nodules ◽  
Thyroid Metastasis ◽  
Term Survival ◽  
Cervical Mass ◽  
Cervical Carcinomas ◽  
Appropriate Treatment ◽  
Rare Case Report

The thyroid gland is a relatively uncommon site for a metastatic disease, although it is richly supplied with blood. The metastases may originate from various primary sites, mainly kidney, lung, head and neck, and breast. Thyroid metastasis from cervical carcinomas is extremely rare; and only a few cases have been previously reported in the literature. In patient with thyroid nodules and an oncological history, the possibility of thyroid metastasis should be seriously considered. Despite the rarity of the metastasis of cervical carcinoma to the thyroid, it is difficult to say appropriate treatment approach for these lesions. When managing such patients, decision-making should balance the possibility of gaining long-term survival against estimation of the aggressiveness of the disease and its possible complications. Here, a case of thyroid metastasis from a squamous cell carcinoma of the uterine cervix presenting with cervical mass and difficulty in swallowing and its treatment is reported.

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