Follicular thyroid carcinoma metastasis to the facial skeleton: a systematic review

Abstract

BackgroundFollicular thyroid carcinoma (FTC) metastasis to the facial skeleton is exceedingly rare. A case of FTC metastasizing to the mandible is presented and a systematic review of the literature describing thyroid metastasis to the facial skeleton is performed.Case presentationA 73-year-old female presented with metastatic FTC to the mandible and underwent total thyroidectomy, segmental mandibulectomy, bone impacted fibular free flap reconstruction, and adjuvant radioactive iodine treatment. The PubMed database was searched for literature describing thyroid cancer with facial skeleton metastasis using the key words “thyroid,” “cancer,” “carcinoma,” “metastasis,” and “malignancy” with “oral cavity,” “maxilla,” “mandible,” “sinus,” “paranasal,” and “orbit.” Reports that only involved the soft tissues were excluded. Systematic review revealed 59 cases of well-differentiated thyroid cancer with facial skeleton metastasis: 35 mandibular metastases (21 = FTC), 6 maxilla metastases (2 = FTC), 9 orbital metastases (4 = FTC), and 11 paranasal sinus metastases (7 = FTC). Treatment included surgery, RAI, external beam radiotherapy (XRT), or a combination of these modalities. The one, two, and five-year survival rates were 100%, 79%, and 16%, respectively.ConclusionFacial skeleton metastasis of FTC is a rare clinical challenge. Optimal treatment appears to include total thyroidectomy and resection of involved structures with or without adjuvant treatment.

Histopathological Spectrum of Non-Neoplastic and Neoplastic Lesions of Thyroid: A Descriptive Cross-sectional Study

“… 27 Varadarajan VV et al have also described facial skeletal metastasis of FC. 28 We also established a case of FC with bony metastasis in the left proximal arm in a 35 years old female. We had 2(2.02%) cases of medullary carcinoma thyroid in our current research which was similar to that presented by Singh SR & Iyengar S, Fatima A et al and Beigh A et al with 2 (2.5%), 8 (3.92%) and 1 (5%) cases respectively.…”

Solitary metastatic deposit in the mandible from follicular thyroid carcinoma

“…[ 6 ] In the article by Varadarajan et al ., the authors summarized 41 reported cases in the literature of thyroid malignancy with metastasis to the mandible, of which 21 reported cases were FTC and from six reported cases of metastasis to the maxilla, two were FTC. [ 7 ]…”

Distant metastasis of follicular thyroid carcinoma to the mandible: a rare case report

“…More recently, in a systematic review literature of 59 cases of thyroid cancer with facial skeleton metastasis, the overall survival rate was 96% at 2 years and 59% at 5 years. Among them, 22 cases were treated with surgery and postoperative radioactive iodine, yielding a survival rate of 100% at 2 years and 71% at 5 years16.…”