Metastases of Well-Differentiated Thyroid Cancer to the Gastrointestinal System

Abstract

Because of the extreme rarity of patients with metastases of thyroid cancer to the gastrointestinal tract, long-term follow-up data as well as information on prognosis are very limited. Aggressive management may provide symptomatic relief or palliation, but cure is unlikely once widespread metastases supervene. Attempts at complete or near-complete surgical resection of the metastases invading the digestive tract, followed by 131-I treatment, offer the best opportunity for improvement but will only rarely result in cure in selected patients.

Pancreatic Metastasis Arising from a BRAFV600E-Positive Papillary Thyroid Cancer: The Role of Endoscopic Ultrasound-Guided Biopsy and Response to Sorafenib Therapy

“…In most patients, pancreatic metastases and other metastatic foci lose their ability to take up RAI (5,7). Six of the eight patients who have been described in the literature and summarized in this report had non-RAI avid pancreatic metastases (8)(9)(10)(11)(12).…”

“…During follow-up, distant metastases develop in 2%-34% of cases (7). The risk of distant metastases is related to the risk group of patients (4,5,17).…”

“…The most common site for abdominal metastases is the liver (7). However, metastases from DTC to the liver represent only 0.5% of all distant metastases from DTC and are frequently part of widespread distant metastases to other organs, although isolated liver metastases have been rarely described (7). Pancreatic metastases from DTC are extremely rare.…”

“…For unclear reasons, other body organs are rarely involved. Metastases to the pancreas are extremely rare (7). So far, only seven cases have been reported in the literature (8)(9)(10)(11)(12)(13).…”

“…So far, only seven cases have been reported in the literature (8)(9)(10)(11)(12)(13). The presence of pancreatic metastases is usually accompanied by widespread metastases to other organs and reflects an advanced stage of the disease (7). In this report, we describe a patient with PTC who had radioinsensitive lung metastases for 6 years before he developed a pancreatic metastasis that was detected on a merged computed tomography (CT)/18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) scan, localized by magnetic resonance imaging (MRI) and confirmed by endoscopic ultrasound (EUS)-guided biopsy.…”