Cutaneous manifestations of thyroid cancer: a report of four cases and review of the literature

Abstract

Cutaneous metastases from thyroid carcinoma are rare. This report describes four cases of thyroid carcinoma metastatic to the skin. Two cases were medullary carcinoma and two were papillary thyroid carcinoma. In two cases, skin metastases were the presenting feature of the underlying thyroid carcinoma. Examination of the skin lesions by conventional light microscopy suggested the possibility of metastatic carcinoma and immunohistochemical tests confirmed the diagnosis. Subsequent investigations identified primary thyroid lesions. In two cases, the skin metastasis was the first evidence of the recurrence of known thyroid carcinoma. These cases identify a novel presentation of thyroid carcinoma.T hyroid carcinoma is the most common endocrine malignancy. It usually presents as a thyroid nodule, but occasionally patients manifest with unusual features. The presence of metastatic disease at the time of diagnosis is a bad prognostic feature, and patients who present with symptomatic metastases do very poorly.

Scalp metastases from thyroid carcinomas: review of clinical and pathological features

“…Additional neuroendocrine markers such as synaptophysin, chromogranin and CD 56 can be identified by IHC staining to diagnose MTC metastases. [6] Thyroid transcription factor-1 (TTF-1) is a 38 kd DNA binding protein, originally detected in follicular cells of the thyroid, thyroid C cells and subsequently in pneumocytes.…”

“…[5,6,[30][31][32] In five cases scalp was the only cutaneous site of metastasis and in one case chest wall was also involved. Alwaheeb et al [6] reported 2 cases of MTC presenting initially with scalp nodules. In the other 4 cases scalp lesions were detected 1 to 4 years after the diagnosis of primary MTC.…”

“…Scalp lesion was the only presenting symptom in three cases. [6,10,11] Data relating to the interval between the diagnosis of the primary tumor and scalp metastasis is not available in two cases. [12,13] Scalp lesions occurred 1.3 to 17 years after the diagnosis of PTC in the remaining 9 cases reported.…”

“…[5] Cutaneous metastases from MTC are extremely rare and scalp is the most common site. [6] The lesions are in the form of solitary or multiple nodules or papules with pinkish or blue color. Thirteen cases of cutaneous metastases from MTC were reported to date.…”

A Case of Medullary Thyroid Carcinoma in which the Skin Metastasis was Concurrently Present and Response Occurred to Chemotherapy

“…These findings were helpful for making a diagnosis of multiple metastases of poorly differentiated thyroid carcinoma and were also useful in following up of treatment response to anti-cancer chemotherapy. The skin metastasis of thyroid carcinoma is a disseminated tumor, and it has a poor prognosis to such an extent that its mean survival is at most 7.5∼19 months (3,4). To date, due to a small number of cases of thyroid medullary cancer, a statistical significance could not be analysed.…”