An H-TERT Mutated Skin Metastasis as First Occurrence in a Case of Follicular Thyroid Carcinoma

Monti, Eugenio; Dono, Mariella; Gonella, Edoardo; Spina, Bruno; Pitto, Francesca; Petrogalli, F.; Conte, Lucia; Ambrosetti, E.; Minuto, Michele; Ansaldo, Gianluca; Morbelli, Silvia; Zupo, Simona; Giusti, Massimo

doi:10.3389/fendo.2019.00513

Cited by 4 publications

(6 citation statements)

References 28 publications

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“…Around 5.4-11% of patients with FTC have distant metastasis, which usually has a poor prognosis and affects the survival of patients (7,8). The most unusual metastatic site reported in the literature is the skin (3,9). In our case, the metastatic site was the soft tissue between the skin and the surface of the sternocleidomastoid muscle.…”

Section: Discussionmentioning

confidence: 61%

Multidisciplinary Diagnosis of Subcutaneous Soft Tissue Metastasis of Follicular Thyroid Carcinoma: A Case Report

2020

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Background: Subcutaneous soft tissue metastasis of follicular thyroid carcinoma (FTC) is rarely diagnosed before surgery for clinicians. Case Report: We present a case of a 67-year-old man with a history of FTC and papillary thyroid microcarcinoma for 5 years. Multiple protruding subcutaneous nodules of the neck were found and removed from the surface of the sternocleidomastoid muscle. Ultrasound, computed tomography and technetium-99 m pertechnetate singlephoton emission computed tomography of the neck were performed before the operation, which unfortunately indicated suspicious malignant lesions. Serum Tg was > 300 ng/ml (0.83-68.0 ng/ml), TSH was 36.580 uIU/ml (0.380-4.340 uIU/ml) and AbTg was negative. The pathologic diagnosis was metastatic FTC, invading the surrounding striated muscle, adipose tissue and vessels. Immunohistochemical staining revealed the tumor cells to be positive for thyroglobulin and TTF-1. The specimens of these nodules were further investigated for TERT promoter mutation and the result revealed mutated type (position g 1,295, 228 C>T). Conclusion: Preoperative diagnosis and prognostic prediction of metastatic FTC may be available through a combination of clinical, multimodal imaging and molecular genetic test (viz. multidisciplinary diagnosis). A long-term standardized follow-up is required for patients with a previous diagnosis of FTC.

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Section: Discussionmentioning

confidence: 61%

Multidisciplinary Diagnosis of Subcutaneous Soft Tissue Metastasis of Follicular Thyroid Carcinoma: A Case Report

2020

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“…The sentinel node is located within central compartment (levels VI and VII); the second station is lateral compartment (levels II, III, IV, and V) followed by contralateral neck region (6). The rarest secondary sites of thyroid cancer involvement that have been cited are at mammary level, renal area as well as pancreas, adrenals, cerebral, ovarian, parotids, and teguments (11,12,13). Cutaneous location varies from neck and head (majority) to exceptional sites as chest wall and of variable incidence for scalp (11,12,14,15).…”

Section: Skin Metastasesmentioning

confidence: 99%

“…The rarest secondary sites of thyroid cancer involvement that have been cited are at mammary level, renal area as well as pancreas, adrenals, cerebral, ovarian, parotids, and teguments (11,12,13). Cutaneous location varies from neck and head (majority) to exceptional sites as chest wall and of variable incidence for scalp (11,12,14,15). Underling neck muscle or Meckel's cave in association with local teguments has also been reported (15,16).…”

Section: Skin Metastasesmentioning

confidence: 99%

“…The skin lesion is usually a lump of medium to small size, sometimes of papular appearance, without local pain (but depends on the site); it may associate local erythema (11,12).…”

Section: Skin Metastasesmentioning

confidence: 99%

“…The diagnosis is difficult to establish unless an index of suspicion is positive (17,18,19). Reports of skin metastases include subjects with follicular and papillary subtypes and also papillary with follicular variant or anaplastic forms among follicular epithelium derived malignancies (11,12,20,21).…”

Section: Skin Metastasesmentioning

confidence: 99%

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Skin metastasis as incidental finding in follicular epithelium derived – thyroid cancer

Şandru¹,

Valea²,

Albu³

et al. 2020

Ro J Med Pract.

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Skin metastases are not typical. Malignancies like mammary cancer (most frequent in females) and pulmonary neoplasia (most frequent in males) represent the majority and exceptional findings are in those originating from thyroid, prostate, ovaries and oesophagus, usually in advanced, generally disseminated stages, with a poor prognosis. It may be found more often in elderly patients. We aim to present some practical aspects of skin metastases in thyroid cancer that originates from follicular thyroid epithelium. This is a brief literature review. The level of evidence is poor since most data is provided from cases reports. Cutaneous malignant lumps are rarely the first sign of disease, mostly associating a cancer relapse. The location varies from neck and head (majority) to exceptional sites as chest wall and of variable rate for scalp. Underling neck muscle or Meckel's cave metastasis may be associated. The lesion is usually a lump of medium to small size, sometimes of papular appearance, without local pain (but depends on the site); it may associate erythema. The diagnosis is difficult unless an index of suspicion is positive (in which case whole body radioiodine scintigram may be useful). Biopsy and histological report are essential for diagnosis especially in cases without an evident connection to a prior/synchronous thyroid malignancy. Knowing the exceptional prevalence, the need for awareness in this particular topic is connected with a multidisciplinary daily practice.

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Thyroid Cancer With Cutaneous Metastases

Sciscent,

Eberly,

Goyal

et al. 2024

Ear Nose Throat J

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Objectives: Thyroid carcinoma with cutaneous metastases is a rare clinical finding. Cutaneous metastases from thyroid carcinoma have been associated with a poor prognosis, but these data are limited to case reports. The exact mechanism of cutaneous metastases from thyroid carcinoma is not clear. Our study aims to report the demographic, clinical, and histologic findings of patients with cutaneous metastases from thyroid carcinoma. Methods: A review was conducted using the Medline/PubMed, Cochrane, and Scopus databases to review literature from inception to May 2023. Data extracted included patient age at diagnosis of cutaneous metastases, patient sex, thyroid carcinoma histotype, location of metastases, the time interval between diagnoses of thyroid carcinoma and cutaneous metastases, and overall survival (OS) from the time of cutaneous metastases. Results: One hundred thirty-six patients were identified and 75 were female. The most common types of thyroid carcinoma with cutaneous metastases were papillary (47.79%), followed by follicular (30.15%), and medullary (11.03%). In addition, 11 cases of anaplastic carcinoma, 2 cases of oncocytic carcinoma, and 2 cases of poorly differentiated thyroid carcinoma were reported. The average age at diagnosis of cutaneous metastases was 63.13 years, and the average time interval between the diagnoses of primary thyroid carcinoma and cutaneous metastases was 48.27 months. The most common location of metastases was the scalp (n = 48). Other common locations included the neck, chest, and face. The OS after diagnosis of metastases was only available in 34 patients with an average of 13.07 months. Of these 34 cases, 10 were medullary, 10 were papillary, 9 were anaplastic, and 5 had follicular carcinoma. Conclusions: This study represents an up-to-date review of the cases of thyroid carcinoma with cutaneous metastases. While cutaneous metastasis remains a rare finding, one needs a high index of suspicion, and their presence portends a poor prognosis.

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An H-TERT Mutated Skin Metastasis as First Occurrence in a Case of Follicular Thyroid Carcinoma

Cited by 4 publications

References 28 publications

Multidisciplinary Diagnosis of Subcutaneous Soft Tissue Metastasis of Follicular Thyroid Carcinoma: A Case Report

Multidisciplinary Diagnosis of Subcutaneous Soft Tissue Metastasis of Follicular Thyroid Carcinoma: A Case Report

Skin metastasis as incidental finding in follicular epithelium derived – thyroid cancer

Thyroid Cancer With Cutaneous Metastases

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