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Metastatic Thyroid Carcinoma (metastatic + thyroid_carcinoma)

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Medical Sciences100%

Selected Abstracts

NEUROLOGICAL DEFICIT AS A PRESENTATION OF OCCULT METASTATIC THYROID CARCINOMA

ANZ JOURNAL OF SURGERY, Issue 10 2006
Mark Izzard
Three cases of occult metastatic thyroid carcinoma presenting with neurological deficits are reviewed. In each case the patient's initial presentation was with symptoms of neurological deficiency secondary to a spinal cord compression. All patients received a combination of surgery, external beam radiotherapy and postoperative thyroxine treatment. Two of the three patients are alive and well, able to mobilize with minor neurological dysfunction. The diagnosis and management of the patients, as well as their outcomes are reviewed, with a discussion on further management issues alongside a review of the current published work. [source]

Follicular thyroid carcinoma: metastasis to the sternum, 13 years after total thyroidectomy

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 11 2006
A. EROGLU
Summary Primary and metastatic malignancies of the sternum are uncommon. Secondary lesions to the sternum occur more commonly in patients with lung and breast cancer, and only a few cases of sternal metastasis arising from a follicular thyroid carcinoma have been reported in the literature. Rarely, metastases to the sternum present in the guise of primary sternal tumours may be treated surgically with that diagnosis in mind. We describe a case of a sternal mass treated by radical surgery, which ultimately proved to be a solitary metastasis from a follicular carcinoma of the thyroid, appearing 13 years after total thyroidectomy and radioactive iodine therapy. Late metastatic thyroid carcinoma to the sternum should be kept in mind in the differential diagnosis of sternal lesions. For patients with thyroid carcinoma and sternal metastasis, we recommend surgical resection of the metastasis, not only as a curative or palliative measure but also to maximise the effect of subsequent radioiodine treatment. [source]

Benign ectopic thyroid tissue in a cutaneous location: a case report and review

JOURNAL OF CUTANEOUS PATHOLOGY, Issue 2 2004
Kim Maino
Background:, For many years, lateral, aberrant thyroid tissue in adults was a term used almost exclusively for metastatic thyroid carcinoma. However, aberrant, benign ectopic thyroid tissue does occur, and it is most commonly found as a part of the evaluation of endocrine dysfunction. Rarely, aberrant, benign ectopic thyroid presents as a primary mass. Case report:, We present a 35-year-old female who presented for removal of a lifelong posterior lateral neck nodule. Results:, Histologic examination and immunohistochemical studies confirmed the presence of aberrant, benign ectopic thyroid tissue. The patient had no endocrine problems, and she had a normally located and functioning thyroid gland. Conclusions:, This case illustrates that not all aberrant thyroid tissues in adults are malignant or associated with endocrine disorders. This case also illustrates the rare association of ectopic thyroid and a normally located and functioning thyroid gland. In this patient, a somatic mutation in a transcription factor important in thyroid migration could explain these findings. [source]

NEUROLOGICAL DEFICIT AS A PRESENTATION OF OCCULT METASTATIC THYROID CARCINOMA

ANZ JOURNAL OF SURGERY, Issue 10 2006
Mark Izzard
Three cases of occult metastatic thyroid carcinoma presenting with neurological deficits are reviewed. In each case the patient's initial presentation was with symptoms of neurological deficiency secondary to a spinal cord compression. All patients received a combination of surgery, external beam radiotherapy and postoperative thyroxine treatment. Two of the three patients are alive and well, able to mobilize with minor neurological dysfunction. The diagnosis and management of the patients, as well as their outcomes are reviewed, with a discussion on further management issues alongside a review of the current published work. [source]

Histopathologic characterization of radioactive iodine-refractory fluorodeoxyglucose-positron emission tomography-positive thyroid carcinoma

CANCER, Issue 1 2008
Michael Rivera MD
Abstract BACKGROUND. Radioactive iodine-refractory (RAIR) 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) positive thyroid carcinomas represent the major cause of deaths from thyroid carcinomas (TC) and are therefore the main focus of novel target therapies. However, to the authors' knowledge, the histology of FDG-PET-positive RAIR metastatic thyroid carcinoma has not been described to date. METHODS. Metastatic tissue from RAIR PET-positive patients identified between 1996 and 2003 at the study institution were selected for histologic examination. The biopsied metastatic site corresponded to a FDG-PET positive lesion sampled within 2 years (87% of which were sampled within 1 year) of the PET scan. Detailed microscopic examination was performed on the metastatic deposit and the available primary tumors. Poorly differentiated thyroid carcinomas (PDTC) were defined on the basis of high mitotic activity (,5 mitoses/10 high-power fields) and/or tumor necrosis. Other types of carcinomas were defined by conventional criteria. The histology of the metastases and primary were analyzed, with disease-specific survival (DSS) as the endpoint. RESULTS. A total of 70 patients satisfied the selection criteria, 43 of whom had primary tumors available for review. Histologic characterization of the metastasis/recurrence in 70 patients revealed that 47.1% (n = 33 patients) had PDTC, 20% (n = 14 patients) had the tall cell variant (TCV) of papillary thyroid carcinoma, 22.9% (n = 16 patients) had well-differentiated papillary thyroid carcinoma (WDPTC), 8.6% (n = 6 patients) had Hurthle cell carcinoma (HCC), and 1.4% (n = 1 patient) had anaplastic carcinomas. The histopathologic distribution of the tumor in the primaries was: PDTC, 51%; TCV, 19%; WDPTC, 23%; and widely invasive HCC, 7%. A differing histology between the primary tumor and metastasis was observed in 37% of cases (n = 16 patients). In the majority of instances (63%; 10 of 16 patients) this was noted as transformation to a higher grade. Of the primary tumors classified as PTC, 70% progressed to more aggressive histotypes in the metastasis. Tumor necrosis and extensive extrathyroid extension in the primary tumor were found to be independent predictors of poorer DSS in this group of patients (P = .015). Approximately 68% of the PDTC primary tumors were initially classified by the primary pathologist as better-differentiated tumors on the basis of the presence of papillary and/or follicular architecture or the presence of typical PTC nuclear features. CONCLUSIONS. Several observations can be made based on the results of the current study. The majority of metastases in patients with RAIR PET-positive metastases are of a histologically aggressive subtype. However, well,differentiated RAIR metastatic disease is observable. Poorly differentiated disease is underrecognized in many cases if defined by architectural and nuclear features alone. The presence of tumor necrosis was found to be a strong predictor of aggressive behavior, even within this group of clinically aggressive tumors. Finally, there is a significant amount of histologic plasticity between primary tumors and metastases that may reflect the genetic instability of these tumors. Cancer 2008. © 2008 American Cancer Society. [source]