A rare case of solitary subcutaneous scalp metastasis from follicular thyroid carcinoma revealed with positron emission tomography/computed tomography: A case report and review

Sağer, Sait; Yılmaz, Sabire; Doner, Rana Kaya; Niyazoğlu, Mutlu; Halaç, Metin; Kanmaz, Bedii

doi:10.4103/0973-1482.136681

Cited by 9 publications

(7 citation statements)

References 6 publications

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“…Certains auteurs ont fait valoir que les patients ont généralement une longue évolution clinique avant le diagnostic de lésion du crâne [5], situation prouvée par Negamine et al dans son étude rapportant 12 cas de métastase sous-cutanée de carcinome vésiculaire, qui ont signalé une durée moyenne de 23,3 ans, du diagnostic de tumeur de la thyroïde jusqu´à la découverte de la métastase du crâne [6], largement supérieur à notre cas, qui avait duré 7 ans. Le traitement des patients présentant des métastases inclus une thyroïdectomie totale, l´excision de la lésion autant que possible et l'administration de la thérapie à l´iode radioactif [7].…”

Section: Discussionunclassified

Métastase géante sous cutanée d'un carcinome vésiculaire de la thyroïde: à propos d'un cas

Andrianandrasana¹,

Razakanaivo²,

Rahantamalala³

et al. 2018

Pan Afr Med J

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La localisation secondaire sous-cutanée de carcinome vésiculaire de la thyroïde est inhabituelle. Elle représente au plus 5,8% de sites métastatiques préférentielles de la thyroïde. Il s'agit d'une femme de 60 ans, présentant une énorme tuméfaction hypervasculaire du tissu sous-cutané du crâne, d'évolution lente, après 7 ans d'une lobectomie droite de la thyroïde. Le bilan anatomo-pathologique a conduit au diagnostic de carcinome vésiculaire de la thyroïde. Une intervention chirurgicale consistait à réduire la lésion du crâne ainsi qu'une thyroïdectomie a été réalisée. Actuellement, elle est en attente d'un traitement par l'iode radio-actif. La métastase de carcinome vésiculaire du scalp existe malgré que c'est rare. Toutefois, à ce stade le pronostic reste défavorable.

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Section: Discussionunclassified

Métastase géante sous cutanée d'un carcinome vésiculaire de la thyroïde: à propos d'un cas

Andrianandrasana¹,

Razakanaivo²,

Rahantamalala³

et al. 2018

Pan Afr Med J

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“…Sağer ve ark. [10] bir olguda soliter skalp metastazını F-18 florodeoksiglukoz (FDG) pozitron emisyon tomografi-bilgisayarlı tomografi (PET/BT) ile görüntülemişlerdir. Bizim vakamızda, skalp metastazına ek olarak mediastinel lenf nodu, akciğer ve kemik metastazları mevcuttu.…”

Section: Discussionunclassified

Scalp metastasis detected incidentally on screening scintigraphy after I-131 therapy from metastatic follicular thyroid cancer

Şengöz¹,

Yaylalı²,

Tezcan³

et al. 2017

Pau Med J

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ÖzetDifferansiye tiroid kanserleri içerisinde folliküler kanser, papiller kansere göre daha sık uzak metastaz yapar. Kutanöz metastaz nadir görülmektedir ve en sık skalp bölgesinde yerleşmektedir. Total tiroidektomi sonrası metastatik olgularda I-131 ablasyon/metastaz tedavisi uygulanmaktadır.Bu yazıda, 63 yaşında kadın metastatik folliküler tiroid kanseri olgusu sunulmuştur.Hastada, I-131 ile radyoiyod tedavisi sonrası 7. günde çekilen tüm vücut tarama sintigrafisinde mediastinel lenf nodu, akciğer ve kemik metastazları yanında kranyum posteriorunda skalp derisinde nodüler lezyon izlenmiş olup, taramaya ek olarak alınan tek foton emisyon tomografisi -bilgisayarlı tomografi (SPECT-BT) sayesinde anatomik lokalizasyonu net olarak yapılmıştır. Eksizyonel biyopsi sonrası folliküler kanser metastazı tanısı almıştır. Pam Tıp Derg 2017;10(3):298-300Anahtar sözcükler:Folliküler tiroid kanseri, skalp metastazı, I-131 tüm vücut tarama sintigrafisi, SPECT-BT. AbstractAmong differentiated thyroid cancers, follicular cancer metastases occur more frequently than papillary carcinoma. Cutaneous metastasis is rare and located most frequently in the region of the skalp. I-131 ablation / metastases treatment is performed in metastatic cases after total thyroidectomy. In this article, we present a 63-year-old woman with metastatic follicular thyroid cancer. On the 7th day after radioiodic treatment with I-131, whole-body scintigraphy showed nodular lesions in the scalp at the posterior cranium besides the mediastinel lymph node, lung and bone metastases. Single foton emission tomography -computered tomography (SPECT-CT) was clearly defined the anatomic localization of the scalp lesion. Follicular cancer metastasis was diagnosed via excisional biopsy. Pam Med J 2017;10(3):298-300Keywords:Follicular thyroid cancer, scalp metastasis, I-131 whole body scintigraphy, SPECT-CT. GirişDiferansiye tiroid kanserleri (DTK) insanda görülen kanserlerin %1'ini oluşturmakta ve kadınlarda erkeklere göre 2-4 kat daha fazla görülmektedir [1]. Endokrin kanserler arasında en sık görülen malignite olup aynı zamanda diğer tüm endokrin kanserlere göre en fazla ölüme neden olan kanser türüdür [2]. Papiller ve folliküler kanserler, DTK' in en sık görülen tipleridir. Folliküler kanserler , papiller kanserlere göre daha fazla uzak metastaz yapma potansiyeli taşır [3]. Uzak metastaz görülme oranı %5-23 arasındadır ve en sık akciğer ve kemiğe metastaz görülmektedir. Folliküler kanserde cilt metastazı nadir görülmektedir ve en sık skalp bölgesine olmaktadır [4]. Folliküler kanserde skalp metastazı görülme oranı %2.5-5.8 dir [5]. DTK'nde güncel tedavi yaklaşımı, total tiroidektomi ve sonrasında I-131 ablasyon/metastaz tedavisidir. Tedavi sonrası I-131 tüm vücut tarama sintigrafisi (TVT) ile metastatik odaklar saptanabilmektedir. Ayrıca TVT'nde saptanan I-131 tutulumlarının anatomik lokalizasyonu için, tek foton emisyon tomografisi (SPECT) ile bilgisayarlı tomografinin (BT) birleştirilmesi ile elde edilen SPECT-BT görüntüleme oldukça faydalı sonuçlar vermektedir.B...

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“…It typically presents as a thyroid nodule, either noted by the patient or the physician on routine physical examination or incidentally on routine imaging ( 1 ). Vascular invasion is characteristic for follicular carcinoma accounting for more common distant metastasis ( 5 ). These metastases occur in 10–15% of patients with FTC, with lung and bone being the commonest sites of involvement.…”

Section: Discussionmentioning

confidence: 99%

“…These skull lesions are osteolytic on skull X-ray, and CT scans generally show homogeneous lesions with density slightly greater than the brain and a highly vascular appearance on angiographic assessment with blood supply most commonly from external carotid system ( 7 , 14 ). In patients with scalp lesions, PET/CT can be used to determine the biopsy site ( 5 ). In patients with established diagnosis of FTC with no documented metastases, evaluation of possible metastatic lesions can be done with (131)I single photon emission CT/CT [(131)I-SPECT/CT] ( 15 ).…”

Section: Discussionmentioning

confidence: 99%

“…Prognosis in case of metastasis is generally poor and the 10-year survival with bone metastases from DTC is reported to be 27% ( 7 ). However, mean survival time of 4.5 years was reported with skull metastases in one case series, suggesting even worse prognosis and warranting an aggressive and multidisciplinary approach in this subset of patients ( 5 ). A regular follow-up is crucial in these patients for early detection and management of any residual or recurrent metastatic FTC ( 6 ).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Thyroid follicular carcinoma presenting as metastatic skin nodules

Jehangir

Pathak

Aryal

et al. 2015

Journal of Community Hospital Internal Medicine Perspectives

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BackgroundFollicular thyroid cancer (FTC) metastasizes most commonly to the lungs and non-cranial bones. Skull and skin are uncommon sites and usually manifest well after the diagnosis of primary malignancy. Metastasis to skull and skin as the presenting feature of FTC is infrequently reported in the literature.Case presentationA 65-year-old Caucasian woman with a history of thyroid nodule presented with the complaint of rapidly growing skull nodules which had been present for 3 years but were stable previously. She denied any fevers, chills, history of trauma, or weight loss. She denied any history of smoking or head and neck irradiation. On physical examination, she had two non-tender gray cystic lesions – one on her left temporal region and the other on the right parietal region. Biopsy was consistent with metastatic FTC. Magnetic resonance imaging of the brain demonstrated 7.1×3.8 cm and 3.7×4.5 cm fairly homogeneous, enhancing, relatively well-defined masses centered in the posterior and left anterior lateral calvarium with intracranial and extracranial extensions but without any vasogenic edema or mass effect on the brain. Thyroid ultrasound showed numerous nodules in both lobes. The patient underwent a total thyroidectomy. Histopathological studies of the thyroid gland revealed a well-differentiated FTC in the left lobe. Then she underwent resection of the tumor in multiple stages. She did not have any recurrence of the FTC or metastases during the follow-up period and will be receiving radioactive iodine treatment.ConclusionBone and lung are the common sites of metastasis from FTC, but involvement of skull or skin is unusual, particularly as the presenting feature. Metastases from FTC should be in the differential of patients with new osteolytic hypervascular skull lesions or cutaneous lesions in head and neck area.

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A rare case of solitary subcutaneous scalp metastasis from follicular thyroid carcinoma revealed with positron emission tomography/computed tomography: A case report and review

Cited by 9 publications

References 6 publications

Métastase géante sous cutanée d'un carcinome vésiculaire de la thyroïde: à propos d'un cas

Métastase géante sous cutanée d'un carcinome vésiculaire de la thyroïde: à propos d'un cas

Scalp metastasis detected incidentally on screening scintigraphy after I-131 therapy from metastatic follicular thyroid cancer

Thyroid follicular carcinoma presenting as metastatic skin nodules

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