A Case of Hemangiosarcoma in Thyroid with Severe Anemia due to Bone Marrow Metastasis

Abstract

Abstract.A 56-year-old woman presented with rapidly enlarging thyroid mass and deep anemia. There was no history of gastrointestinal bleeding, and endoscopic examinations of the gastrointestinal system were normal. Fine needle aspiration cytology from the thyroid nodule was suspicious. After blood transfusion, total thyroidectomy was performed. Postoperative histopathological examination of the specimen revealed hemangiosarcoma of the thyroid. After establishment of the diagnosis chemotherapy was started. But hemoglobin values decreased again and hepatosplenomegaly developed at the second month of surgery. Bone marrow aspiration cytology which was performed demonstrated the same tumoral cells infiltrating bone marrow. The patient died at 12th week after surgery. Thyroid hemangiosarcoma can metastasize to the bone marrow and anemia may be an indicator of the advanced disease. In the differential diagnosis of the anemia, bone marrow metastasis and bone marrow biopsy should be considered in suspected cases.

Nonalpine Thyroid Angiosarcoma in a Patient with Hashimoto Thyroiditis

“…As previously reported by other authors, its incidence is the highest in the European Alpine regions and in some European areas as Northern Italy, Austria, and Switzerland it can constitute the 2–10% of malignant thyroid tumors [1–3]. In Southern Italy, no case of thyroid angiosarcoma has been described.…”

Primary thyroid angiosarcoma: an unusual localization

“…In fact, this type of cancer typically metastasizes in the first instance at the level of regional lymph nodes and the lungs, and in the late stages in the bone marrow [12]. A very wide surgical excision is the management of choice in cases of radically removable tumor.…”

Angiosarcoma Thyroid: Case Report and Review of Literature

“…As regards adjuvant therapy, some say that, after the radical excision of the tumor, radiotherapy and then chemotherapy are indicated [6]; others claim that, if the tumor is not corroded surgically and if the patient is subjected to radiotherapy and chemotherapy it represents only a palliative treatment because the first step of choice is radical surgical excision of the tumor. Regarding prognosis of the tumor, poor outcomes occur mostly with extracapsular tumor spread and distant metastasis [2] [4] [6] [8].…”

“…It rapidly involves the regional lymph nodes and sometimes lungs; also rarely the bone marrow [5]. The main line of treatment is radical surgery followed by radiotherapy and sometimes chemotherapy may also be needed [6].…”