Differentiated Thyroid Carcinoma: Distant Metastasis as an Unusual Sole Initial Manifestation

Objective: It is still controversial whether differentiated thyroid carcinoma (DTC) in patients with Graves disease (GD) can be more aggressive than non-Graves DTC. We conducted a systematic review and meta-analysis to examine the association between GD and prognosis in patients with DTC. Methods: We comprehensively searched the databases of MEDLINE and EMBASE from inception to March 2019. We included published studies that compared the risk of mortality and prognosis between DTC patients with GD and those with non-GD. Data from each study were combined using the random-effects model. Results: Twenty-five studies from February 1988 to May 2018 were included (987 DTC patients with GD and 2,064 non-Graves DTC patients). The DTC patients with GD had a significantly higher risk of associated multifocality/multicentricity (odds ratio, 1.45; 95% confidence interval, 1.04 to 2.02; I 2, 6.5%; P = .381) and distant metastasis at the time of cancer diagnosis (odds ratio, 2.19; 95% confidence interval, 1.08 to 4.47; I 2, 0.0%; P = .497), but this was not associated with DTC-related mortality and recurrence/persistence during follow-up. Conclusion: Our meta-analysis demonstrates a statistically significant increased risk of multifocality/multicentricity and distant metastasis at the time of cancer diagnosis in DTC patients with GD than those without GD. Abbreviations: CI = confidence interval; DTC = differentiated thyroid carcinoma; GD = Graves disease; LN = lymph node; OR = odds ratio; PTC = papillary thyroid carcinoma; TC = thyroid carcinoma; TSAb = thyroid-stimulating antibody; TSH = thyroid-stimulating hormone

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Abstract #235: Neck Recurrence and Distant Metastasis in Patients With pT1N0Mx Differentiated Thyroid Carcinoma (DTC)

Endocrine Practice ◽

10.1016/s1530-891x(20)44002-9 ◽

2006 ◽

Vol 12 ◽

pp. 77-78

Author(s):

Andrea Frasoldati ◽

Verter Barbieri ◽

Diana Salvo ◽

Giorgio Gardini ◽

Roberto Valcavi

Keyword(s):

Thyroid Carcinoma ◽

Distant Metastasis ◽

Differentiated Thyroid Carcinoma ◽

Neck Recurrence

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Cerebellum as Initial Site of Distant Metastasis from Papillary Carcinoma of Thyroid: Review of Three Cases

Case Reports in Neurological Medicine ◽

10.1155/2015/171509 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5

Author(s):

Mutahir A. Tunio ◽

Mushabbab Al Asiri ◽

Khalid Hussain AL-Qahtani ◽

Wafa AlShakweer

Keyword(s):

Thyroid Carcinoma ◽

Distant Metastasis ◽

Survival Rates ◽

Intensity Modulated Radiation Therapy ◽

Differentiated Thyroid Carcinoma ◽

Cerebellar Hemisphere ◽

Histopathological Diagnosis ◽

Suboccipital Craniectomy ◽

Left Cerebellar Hemisphere ◽

Case Presentations

Background. The cerebellum as initial site of distant metastasis from differentiated thyroid carcinoma (DTC) including papillary (PTC) and follicular thyroid carcinoma (FTC) is rare manifestation.Case Presentations. Herein, we present three cases of cerebellar metastasis (CBM) of PTC. Mean age of patients was 67 years (range: 64–72), and mean duration between initial diagnosis and CBM was 49.6 months (range: 37–61). Frequent location was left cerebellar hemisphere and was associated with hydrocephalus. All patients underwent suboccipital craniectomy, and in two patients postoperative intensity modulated radiation therapy (IMRT) was given to deliver 5000 cGy in 25 fractions to residual lesions. Patient without postoperative IMRT had cerebellar recurrence along with lung and bone metastasis after 38 months. However, two patients were found alive and free of disease at the time of last follow-up.Conclusion. CBM from PTC is a rare clinical entity and is often associated with hydrocephalus. Histopathological diagnosis is important to initiate effective treatment, which relies on multidisciplinary approach to prolong the disease-free and overall survival rates.

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