Tumor-to-tumor Metastases to Follicular Variant of Papillary Thyroid Carcinoma: Histologic, Immunohistochemical, and Molecular Studies of Two Unusual Cases

Yu, Jing; Nikiforova, Marina N.; Hodak, Steven P.; Yim, John H.; Cai, Guoping; Walls, Andrew; Seethala, Raja R.

doi:10.1007/s12022-009-9087-x

Cited by 34 publications

(43 citation statements)

References 19 publications

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“…MTC is a relatively rare type of primary thyroid carcinoma, accounting for only about 5% of all thyroid carcinomas. The majority of previously reported recipient primary thyroid carcinomas were PTC, including FVPTC (12 among 14 cases) (1, 2, 3, 5, 6, 7, 9, 11). The other two cases were oncocytic/hurthle cell carcinomas (4, 8).…”

Section: Discussionmentioning

confidence: 99%

“…Fourteen cases of metastatic tumor to the primary thyroid carcinoma have been reported previously in the literature. The majority of reported primary thyroid carcinomas were papillary thyroid carcinoma (PTC), including follicular variant papillary thyroid carcinoma (FVPTC) (1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11). To our knowledge, there has been no reported case of a tumor metastasizing to medullary thyroid carcinoma (MTC).…”

Section: Introductionmentioning

confidence: 99%

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Metastasis of Colon Cancer to Medullary Thyroid Carcinoma: A Case Report

Yeo

Kim

et al. 2014

J Korean Med Sci

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Metastasis to the primary thyroid carcinoma is extremely rare. We report here a case of colonic adenocarcinoma metastasis to medullary thyroid carcinoma in a 53-yr old man with a history of colon cancer. He showed a nodular lesion, suggesting malignancy in the thyroid gland, in a follow-up examination after colon cancer surgery. Fine needle aspiration biopsy (FNAB) of the thyroid gland showed tumor cell clusters, which was suspected to be medullary thyroid carcinoma (MTC). The patient underwent a total thyroidectomy. Using several specific immunohistochemical stains, the patient was diagnosed with colonic adenocarcinoma metastasis to MTC. To the best of our knowledge, the present patient is the first case of colonic adenocarcinoma metastasizing to MTC. Although tumor-tumor metastasis to primary thyroid carcinoma is very rare, we still should consider metastasis to the thyroid gland, when a patient with a history of other malignancy presents with a new thyroid finding.Graphical Abstract

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Metastasis of Colon Cancer to Medullary Thyroid Carcinoma: A Case Report

Yeo

Kim

et al. 2014

J Korean Med Sci

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“…Our case of poorly differentiated carcinoma of lung metastatic to a follicular adenoma meets these criteria of a true tumor-to-tumor metastasis. Defined in this way, approximately 150 case reports of tumor-to-tumor metastasis exist in the literature [22, 25]. Renal cell carcinoma, meningioma, and thyroid neoplasms are frequent recipients in tumor-to-tumor metastasis [22, 25, 26].…”

Section: Discussionmentioning

confidence: 99%

“…Defined in this way, approximately 150 case reports of tumor-to-tumor metastasis exist in the literature [22, 25]. Renal cell carcinoma, meningioma, and thyroid neoplasms are frequent recipients in tumor-to-tumor metastasis [22, 25, 26]. Common donor tumors in tumor-to-tumor metastasis include carcinomas of lung, breast, stomach, prostate, and thyroid, among others [25].…”

Section: Discussionmentioning

confidence: 99%

Tumors Metastatic to Thyroid Neoplasms: A Case Report and Review of the Literature

Stevens

Richards

Bewtra

et al. 2011

Pathology Research International

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Metastasis into a thyroid neoplasm—tumor-to-tumor metastasis—is exceedingly rare. We describe the 28th documented case of a tumor metastatic to a thyroid neoplasm and review the literature on tumor-to-tumor metastasis involving a thyroid neoplasm as recipient. All cases showed a recipient thyroid neoplasm with an abrupt transition to a morphologically distinct neoplasm. Metastasis into primary thyroid neoplasm was synchronous in 33% of cases and metachronous in 67%. Follicular adenoma was the most common recipient thyroid neoplasm overall (16/28), and papillary thyroid carcinoma was the most common malignant recipient neoplasm (9/28). Of the 9 recipient papillary carcinomas, 6 were follicular variants. Renal cell carcinoma was the most common neoplasm to metastasize to a primary thyroid neoplasm (9/28), followed by lung (6/28), breast (5/28), and colon (3/28) carcinoma. Tumor-to-tumor metastasis should be considered whenever a dimorphic pattern is encountered in a thyroid tumor.

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“…Among these tumors, renal cell carcinoma has been the most frequent metastatic malignancy to the thyroid gland followed by those originating from the lung, gastrointestinal tract, breast, and various other tumors [3]. Interestingly, renal cell carcinoma was also the most frequent primary malignancy metastasizing to primary follicular epithelial derived thyroid neoplasm (Table 1) [4][5][6][7][8][9][10][11]. The presented case is another rare example of a solitary thyroid nodule While a comprehensive panel of markers including PAX8, TTF-1, and thyroglobulin is helpful in the distinction of thyroid follicular epithelial origin, one has to recognize the limitations associated with a single use of individual stains.…”

Section: Commentmentioning

confidence: 99%

An Unusual Solitary Thyroid Nodule with Bloody Follicles: Metastatic Renal Cell Carcinoma Within an Infiltrative Follicular Variant Papillary Carcinoma

Kefeli

Mete

2016

Endocr Pathol

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An 80-year-old woman with a recent diagnosis of invasive mammary carcinoma was found to have a left thyroid mass during routine physical examination. There was no previous exposure to ionizing radiation or known family history of thyroid cancer. Laboratory testing showed a normal TSH along with thyroid auto-antibodies. Ultrasound identified a mass measuring up to 4.0 cm. No cervical lymphadenopathy was detected. A fine-needle aspiration biopsy was performed at an outside institution. Subsequently, the patient was referred for diagnostic left hemithyroidectomy.What Is Your Diagnosis? Figures 1, 2, 3, and 4.Clinicopathological Diagnosis Metastatic renal cell carcinoma within an infiltrative follicular variant papillary thyroid carcinoma.Gross examination of the specimen confirmed a 4.0-cm tan-brown, encapsulated solid nodule with areas of hemorrhage and cystic degeneration (Fig. 1). On histological examination, the tumor displayed follicular (30 %) and solid (70 %) architecture ( Fig. 1). While the component with conventional follicular architecture displayed nuclear features of papillary thyroid carcinoma characterized by nuclear membrane irregularities and chromatin margination in enlarged nuclei, areas with solid growth had relatively smaller nuclei with nuclear membrane irregularities (Fig. 2). The solid component exhibited variable clear cell change as well as scattered follicle-like structures with a central core rich in red blood cells leading to an appearance of Bbloody follicles^ (Fig. 2). Scattered abortive papillary structures lacking true fibrovascular cores and histiocytic infiltrate were seen in the solid region (Fig. 2). No evidence of necrosis was noted. The mitotic count was less than 3 per 10 high-power fields. Cystic change was closely associated with fine-needle aspiration-related changes. There was evidence of multifocal transcapsular invasion associated with both solid and follicular architecture (Fig. 3). No evidence of extra-thyroidal extension, lymphatic invasion, or vascular invasion was found in the submitted sections. The conventional follicular component was positive for PAX8, TTF-1, and thyroglobulin, whereas the solid areas were negative for TTF-1 and thyroglobulin, and were positive for PAX8 (Fig. 4). Both regions were negative for GATA-3, parathyroid hormone, chromogranin-A, monoclonal CEA, and calcitonin. Vimentin was expressed throughout the tumor (Fig. 4). CD10 expression was prominent in the solid component (Fig. 4), but weak and patchy staining was also noted in the conventional follicular component. Positivity for PAX8, CD10, and vimentin along with negativity for TTF-1 and thyroglobulin in the solid component confirmed the diagnosis of metastatic renal cell carcinoma within an infiltrative follicular variant papillary carcinoma was rendered. Subsequently, we were informed that the patient had undergone radical nephrectomy 18 years ago for renal cell carcinoma.

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Tumor-to-tumor Metastases to Follicular Variant of Papillary Thyroid Carcinoma: Histologic, Immunohistochemical, and Molecular Studies of Two Unusual Cases

Cited by 34 publications

References 19 publications

Metastasis of Colon Cancer to Medullary Thyroid Carcinoma: A Case Report

Metastasis of Colon Cancer to Medullary Thyroid Carcinoma: A Case Report

Tumors Metastatic to Thyroid Neoplasms: A Case Report and Review of the Literature

An Unusual Solitary Thyroid Nodule with Bloody Follicles: Metastatic Renal Cell Carcinoma Within an Infiltrative Follicular Variant Papillary Carcinoma

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