Synchronous and Antecedent Nonthyroidal Malignancies in Patients with Papillary Thyroid Carcinoma

Abstract

Background There is a known association between the development of papillary thyroid cancer (PTC) after a primary non-thyroidal cancer (NTC). However, the prevalence of synchronous or antecedent NTCs in patients with PTC is undetermined, as are the clinicopathologic characteristics of PTC in these patients. Study Design A review was performed of our prospectively maintained PTC database between January 1995 and December 2010. Information collected included patient and tumor characteristics, past medical history, PTC presentation, and treatment modality. Results 433 adult patients underwent thyroid resection for PTC. 67 cases of synchronous or antecedent NTCs were observed in 60 patients (13.9%). The most commonly associated antecedent NTCs were breast (n=11), prostate (n=8), and melanoma (n=5), while renal cell carcinoma (n=3) and melanoma (n=3) were the synchronous NTCs most observed. Compared to patients without an NTC, those with an NTC were older (56.4±15.5 vs 44.9±14.2 years, p<0.0001), experienced prior radiation exposure (35.0% vs 3.5%, p<0.001), and more commonly presented with a thyroid mass incidentally on imaging (41.7% vs 9.1%, p=<0.001). PTC tumor characteristics were similar between groups, except that NTC patients presented at a more advanced stage. However, when analyzed independently, primary tumor size, and nodal and distant metastases were comparable. Conclusions The prevalence of synchronous or antecedent NTCs in patients surgically treated for PTC is 13.9%. These patients present with similar PTC tumor characteristics as those without additional NTCs, and should therefore be managed equivalently. In addition, surgeons should be aware of the frequency of synchronous PTC with these types of tumors and consider evaluation of the neck at the time of NTC diagnosis.

Synchronous primary cancers of the thyroid and breast: A case report and review of the literature

“…Synchronous primary tumors are rare, however, epidemiological studies of multiple primary tumors are currently ongoing ( 1 – 5 ). A population-based retrospective cohort analysis conducted by Chen et al ( 2 ) identified that females with a history of thyroid carcinoma have an increased risk of developing BC, particularly premenopausal Caucasian females ( 1 , 3 ).…”

“…Thus, according to the above-mentioned literature, a history of thyroid carcinoma may increase the risk of BC. Furthermore, Murray et al ( 5 ) reported that BC was the most common type of primary non-thyroidal cancer associated with the subsequent development of PTC and that primary non-thyroidal cancer PTC patients presented at a more advanced stage. A previous study indicated that radiotherapy to treat cancer patients may increase the risk of developing a second malignancy ( 3 ).…”

“…Thus, following treatment of primary breast or thyroid cancer, follow-up and screening may be appropriate. Surgeons should be aware of the frequency of synchronous PTC and consider evaluation of the neck during the diagnosis of non-thyroidal malignancies, particularly for patients being diagnosed with breast, prostate, melanoma or renal cell carcinoma ( 5 ). The present case was promptly diagnosed due to the pronounced mass in the anterior region of the neck.…”

“…Contrast-enhanced ultrasound and microvessel density were identified as efficacious optical methods for evaluating the microcirculation of thyroid cancer in Chinese females with BC ( 20 ) and immunohistochemical staining of tissue sections has improved the differential diagnosis in these types of lesion. A previous study identified that patients initially diagnosed with non-thyroidal cancer present with PTC tumor characteristics that are similar to patients with no history of cancer ( 5 ), therefore, treatment should be the same for PTC patients whether they have a history of cancer or not. As the presence of thyroid disease did not appear to affect the prognosis of females with BC ( 21 ), the present report proposes modified radical mastectomy.…”

Meta-Analyses of Epidemiologic Associations between Cutaneous Melanoma and Thyroid Cancer

“…There were two population-based studies that reported incidence rather than risk-one reported on 8 individuals with TC after primary CM, and one reported on 7 individuals with CM after primary TC; these were excluded [3,4]. Characteristics of the included population-based studies are summarized in Table 1 Scotland (1975Scotland ( -1996.…”