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 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 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 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 SUN-486 Unusual Presentation of Metastatic Follicular Thyroid Cancer

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Nikoletta Proudan ◽  
Kersthine Andre
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Follicular Carcinoma ◽  
Cord Compression ◽  
Whole Body ◽  
Follicular Thyroid Cancer ◽  
Lower Extremity Weakness ◽  
History Of ◽  
The Right ◽  
Work Up

Abstract Distant metastasis of follicular thyroid cancer to the bone has been well documented. However, spinal cord compression as the initial presentation of metastatic follicular thyroid cancer without any thyroid symptoms is relatively rare. Here we discuss such a case. A 78-year-old female with history of HTN and melanoma presented to the ED with a 1-month history of middle back pain that progressed to lower extremity weakness, numbness, and inability to ambulate. MRI showed a T7 vertebral mass with cord compression and edema. Metastatic work up was unremarkable except for incidental bilateral thyroid nodules, the largest on the right lobe, at 1.6 cm, with peripheral calcifications. The patient underwent T6-T7 laminectomy with vertebral decompression, partial colpectomy, and T4-T10 fusion. Pathology of the thoracic vertebral mass was positive for CAM 5.2, cytokeran 7, TTF-1, and PAX8 consistent with either metastatic pulmonary adenocarcinoma or thyroid carcinoma. The patient denied shortness of breath, dysphagia, hoarseness, or neck tenderness. She had no personal history of hyperthyroidism or hypothyroidism, or radiation exposure. She also did not have any family history of thyroid cancer. Laboratory work up was significant for TSH of 3.71 mcU/mL (0.4-4.0 mcU/mL), Free T4 1.56 ng/dL (0.7-1.9 ng/dL), thyroglobulin (Tg) 6940 ng/mL (1.6-55.0 ng/mL), and thyroglobulin antibody (Tg Ab) 20 IU/mL (0-115 IU/mL). FNA of the right thyroid nodule showed follicular neoplasm with very similar morphological features to the epidural pathology, favoring a follicular carcinoma. She underwent total thyroidectomy. Pathology showed a 1.6 x 1.1 cm follicular carcinoma with capsular and angiolymphatic invasion, but with uninvolved margins of resection. TNM staging was pT1b, pNx, pM1. She was ablated with 109 mCi of I-131 after withdrawal therapy. Whole body scan after treatment revealed radioiodine avid metastatic disease at T7 and activity in the thyroid bed compatible with residual thyroid tissue. Patient completed 10 fractions of external beam radiotherapy to the spine for a total of 30 Gy. Three months follow up lab work showed Tg 580 ng/mL and negative Tg Ab with a suppressed TSH. Thyroid bed ultrasound did not show any residual tissue or abnormal lymph nodes. Ten-year survival rates in patients with bony metastatic differentiated thyroid cancer range from 13-21% (1). Metastatic thyroid carcinoma should be considered in the differential diagnosis of every patient with new onset bony metastasis and thyroglobulin should be considered as a tumor marker in the initial work up. Research shows increased survival with I-131 avidity and complete bone metastasis resection (1). 1. Ramadan, Sami et al. “Spinal metastasis in thyroid cancer.” Head & neck oncology vol. 4 39. 25 Jun. 2012, doi:10.1186/1758-3284-4-39

scholarly journals Esophageal Metastasis from Carcinoma Thyroid

2010 ◽  
Vol 1 (2) ◽  
pp. 129-131
Author(s):  
Arvind Krishnamurthy ◽  
KT Siddappa ◽  
Shirley Sundersingh ◽  
Satish Srinivas ◽  
Krishna Kumar
Keyword(s):  
Papillary Carcinoma ◽  
Soft Tissues ◽  
Follicular Carcinoma ◽  
Distant Metastases ◽  
Differentiated Thyroid Carcinoma ◽  
Papillary Carcinoma Thyroid ◽  
Esophageal Metastasis ◽  
Well Differentiated ◽  
Differentiated Thyroid Cancers ◽  
Follicular Carcinoma Thyroid

Abstract The incidence of hematogenous spread at the time of presentation of well-differentiated thyroid carcinoma is the range of 4 to 15%. Distant metastases in the most common cause of death from well-differentiated thyroid cancers. About 5% of papillary carcinoma and 25% of follicular carcinoma develop distant metastases. Distant metastases occur largely in the lungs and to a lesser extent in the bones, brain and soft tissues. We report and discuss the management of an elderly gentleman with papillary carcinoma thyroid metastatic to the esophagus on follow-up. Only one similar published report is described which was from a follicular carcinoma thyroid. Our case of a papillary carcinoma thyroid metastatic to the esophagus seems to be the first if its kind.

scholarly journals Adrenal metastasis as the initial diagnosis of synchronous papillary and follicular thyroid cancer

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Xin He ◽  
Scott A. Soleimanpour ◽  
Gregory A. Clines
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Nodules ◽  
Follicular Thyroid Carcinoma ◽  
Distant Metastases ◽  
Needle Aspiration ◽  
Left Lobe ◽  
Adrenal Metastasis ◽  
Bethesda Classification ◽  
The Right

Abstract Background Differentiated thyroid cancer uncommonly presents with distant metastases. Adrenal metastasis from differentiated thyroid cancer presenting as the initial finding is even less common. Case Presentation A 71-year-old male was incidentally found on chest CT to have bilateral thyroid nodules, which were confirmed on ultrasound. Fine needle aspiration of the dominant right 3.3 cm nodule contained histologic features most consistent with Bethesda classification III, and repeat fine needle aspiration revealed pathology consistent with Bethesda classification II. Follow-up thyroid ultrasound showed 1% increase and 14% increase in nodule volume at one and two years, respectively, compared to baseline. Prior to the second annual thyroid ultrasound, the patient was incidentally found to have a 4.1 cm heterogeneously enhancing mass in the right adrenal gland on CT of the abdomen and pelvis. Biochemical evaluation was unremarkable with the exception of morning cortisol of 3.2 µg/dL after dexamethasone suppression. The patient then underwent laparoscopic right adrenal gland excision, which revealed metastatic follicular thyroid carcinoma. Total thyroidectomy was then performed, with pathology showing a 4.8 cm well-differentiated follicular thyroid carcinoma of the right lobe, a 0.5 cm noninvasive follicular thyroid neoplasm with papillary-like nuclear features of the left lobe, and a 0.1 cm papillary microcarcinoma of the left lobe. Thyrotropin-stimulated whole body scan showed normal physiologic uptake of the remnant thyroid tissue without evidence of other iodine avid disease. The patient then received radioactive iodine. At follow-up 14 months after total thyroidectomy, he remains free of recurrent disease. Conclusion Despite following the recommended protocol for evaluation and surveillance of thyroid nodules, thyroid cancer can be challenging to diagnose, and may not be diagnosed until distant metastases are identified.

THE RISK OF THYROID CANCER IN PATIENTS WITH THYROID NODULE 3 CM OR LARGER

2020 ◽  
Vol 26 (11) ◽  
pp. 1286-1290
Author(s):  
Edy Kornelius ◽  
Shih-Chang Lo ◽  
Chien-Ning Huang ◽  
Yi-Sun Yang
Keyword(s):  
Thyroid Cancer ◽  
Positive Predictive Value ◽  
Thyroid Carcinoma ◽  
Thyroid Nodule ◽  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Fine Needle

Objective: There are conflicting data on the risk of thyroid cancer in thyroid nodules 3 cm or larger, and few such studies on this issue have been conducted in Asia. This study aimed to examine the risk of thyroid cancer in patients with thyroid nodules 3 cm or larger. Methods: This was a 7-year retrospective study conducted in a tertiary referral hospital in Taiwan. All patients with a thyroid nodule measuring ≥3 cm who underwent thyroid operation with or without fine-needle aspiration biopsy (FNAB) were included. The prevalence rate of thyroid cancer, as well as the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and false-negative rate of FNAB for thyroid nodule ≥3 cm were also examined. Results: A total of 132 patients were included in this study. Thyroid cancer was detected in 19 of 132 (14.4%) thyroid nodules measuring ≥3 cm. The performance of FNAB for detecting cancer in nodules 3 cm or larger without considering other ultrasonography parameters was relatively poor with a sensitivity of 50%, but the specificity (100%), PPV (100 %), and NPV (93.4 %) were excellent. Conclusion: The risk of thyroid cancer for thyroid nodules ≥3 cm in this study was low. The PPV and NPV of FNAB were high for the detection of cancer in large nodules. The decision to perform thyroidectomy should not be solely based on nodule size and should include other factors, such as ultrasound characteristics and surgical risk. Abbreviations: ATA = American Thyroid Association; FNAB = fine-needle aspiration biopsy; mPTC = micropapillary thyroid carcinoma; NPV = negative predictive value; PPV = positive predictive value; PTC = papillary thyroid carcinoma

Cutaneous seeding of a follicular thyroid cancer after fine-needle aspiration biopsy?

1994 ◽  
Vol 10 (2) ◽  
pp. 156-158 ◽  
Author(s):  
C. Panunzi ◽  
D. S. Paliotta ◽  
E. Papini ◽  
L. Petrucci ◽  
R. Rinaldi ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Follicular Thyroid Cancer ◽  
Fine Needle ◽  
Needle Aspiration Biopsy

scholarly journals A Screening Study of Thyroid Cancer and Other Thyroid Diseases among Individuals Exposed in Utero to Iodine-131 from Chernobyl Fallout

2009 ◽  
Vol 94 (3) ◽  
pp. 899-906 ◽  
Author(s):  
M. Hatch ◽  
A. Brenner ◽  
T. Bogdanova ◽  
A. Derevyanko ◽  
N. Kuptsova ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Odds Ratio ◽  
Needle Aspiration ◽  
In Utero ◽  
Thyroid Diseases ◽  
Chernobyl Fallout ◽  
Cross Sectional ◽  
Screening Study ◽  
Iodine 131

Abstract Background: Like stable iodine, radioiodines concentrate in the thyroid gland, increasing thyroid cancer risk in exposed children. Data on exposure to the embryonic/fetal thyroid are rare, raising questions about use of iodine 131 (I-131) in pregnant women. We present here estimated risks of thyroid disease from exposure in utero to I-131 fallout from the Chernobyl nuclear accident. Methods: We conducted a cross-sectional thyroid screening study (palpation, ultrasound, thyroid hormones, and, if indicated, fine needle aspiration) from 2003 to 2006. Participants were 2582 mother-child pairs from Ukraine in which the mother had been pregnant at the time of the accident on April 26, 1986, or 2 months after the time during which I-131 fallout was still present (1494 from contaminated areas, 1088 in the comparison group). Individual cumulative in utero thyroid dose estimates were derived from estimated I-131 activity in the mother’s thyroid (mean 72 mGy; range 0–3230 mGy). Results: There were seven cases of thyroid carcinoma and one case of Hurthle cell neoplasm identified as a result of the screening. Whereas the estimated excess odds ratio per gray for thyroid carcinoma was elevated (excess odds ratio per gray 11.66), it was not statistically significant (P = 0.12). No radiation risks were identified for other thyroid diseases. Conclusion: Our results suggest that in utero exposure to radioiodines may have increased the risk of thyroid carcinoma approximately 20 yr after the Chernobyl accident, supporting a conservative approach to medical uses of I-131 during pregnancy.

scholarly journals Lymph Node Thyroglobulin Measurement in Diagnosis of Neck Metastases of Differentiated Thyroid Carcinoma

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Luca Giovanella ◽  
Luca Ceriani ◽  
Sergio Suriano
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
Differentiated Thyroid Carcinoma ◽  
Receiver Operating Curve ◽  
Cervical Lymph Nodes ◽  
Receiver Operating Curve Analysis ◽  
Needle Aspiration Cytology ◽  
Sensitivity Specificity

Aim. Enlarged cervical lymph nodes (LNs) in patients with thyroid cancer are usually assessed by fine-needle aspiration cytology (FNAC). Thyroglobulin (Tg) is frequently elevated in malignant FNAC needle wash specimens (FNAC-Tg). The objectives of the study were to (1) determine an appropriate diagnostic cut-off for FNAC-Tg levels (2) compare FNAC and FNAC-Tg results in a group of 108 patients affected by differentiated thyroid carcinoma (DTC).Methods. A total of 126 consecutive FNACs were performed on enlarged LNs and the final diagnosis was confirmed by surgical pathology examination or clinical follow-up. The best FNAC-Tg cut-off level was selected by receiver operating curve analysis, and diagnostic performances of FNAC and FNAC-Tg were compared.Results. The rate of FNAC samples adequate for cytological examination was 77% in contrast FNAC-Tg available in 100% of aspirates (). The sensitivity, specificity, and accuracy of FNAC were 71%, 80%, 74%, 100%, 80%, and 94%, respectively. The most appropriate cut-off value for the diagnosis of thyroid cancer metastatic LN was 1.1 ng/mL (sensitivity 100%, specificity 100%).Conclusions. The diagnostic performance of needle washout FNAC-Tg measurement with a cut-off of 1.1 ng/mL compared favorably with cytology in detecting DTC node metastases.

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