Hürthle Cell Carcinoma of the Thyroid with Contralateral Malignant Pleural Effusion

Abstract

Background: Thyroid cancers with pulmonary metastases have been well documented. However, malignant pleural effusion has rarely been reported. Case Report: We present a 77-year-old patient who had Hürthle cell carcinoma of the thyroid with contralateral malignant pleural effusion. The diagnosis was based on consistency in the histopathological and immunohistochemical features of pleural fluid cytology and the final pathology of the thyroid tumor. Results: The patient was treated with total thyroidectomy and postoperative radioactive-iodine ablation. Unfortunately, he died for recurrent pleural effusion and pulmonary complication 6 months later. Conclusion: Identifying the origin of malignant pleural effusion is important to provide treatment guidance. In this report, we review the literature on diagnosis and treatment of thyroid cancer with malignant pleural effusion.

Notable Decrease of Malignant Pleural Effusion After Treatment with Sorafenib in Radioiodine-Refractory Follicular Thyroid Carcinoma

“…Typically, the presence of MPE portends a dismal prognosis, with a reported median survival of 11 months (4). To the best of our knowledge, MPE has been found only in patients with PTC, with the exception of one patient with a Hürthle cell carcinoma (4,17,18). Hence, this is the first report of MPE caused by FTC.…”

“…During this interval, another course of 131 I therapy using a high dose of 7400 MBq still failed to control the progression of the disease, indicating a poor outcome. 18 F-FDG uptake often reveals malignant tumors because neoplastic cells exhibit increased rates of glycolysis and glucose consumption with accelerated production of glucose transport proteins (21). In a review, the maximum standard uptake values (SUVmax) were collected from eight studies, and the mean SUVmax was calculated as 4.8-3.1 for benign lesions versus 6.9-4.7 for malignant lesions.…”

Metastatic thyroid carcinoma presenting as malignant pleural effusion: A cytologic review of 5 cases

“…6 However, these comprise a very small fraction (<5%) of the total thyroid carcinomas and hence, detection in pleural fluid is extremely uncommon. 13,14 In the study by Olson et al diagnosis of thyroid primary was aided by presence of several classic features of papillary thyroid carcinoma. Vassilopoulou et al describe 10 cases of differentiated thyroid carcinomas presenting with MPE, over 4 decades at the MD Anderson cancer center.…”

Malignant Pleural Effusion Resulting from Metastasis of Thyroid Primaries: A Cytomorphological Analysis

“…Metastatic carcinoma from the thyroid to the pleural space is a much less common occurrence. The largest series to date [4] consists of 10 cases and calculated the incidence of malignant effusion due to metastatic papillary thyroid carcinoma (PTC) to be 0.6%, and only 3 other case reports have demonstrated this disease manifestation in individual patients [5,6,7]. The cytomorphological features have only rarely been described in a case report [7].…”