Unusual Thyroid Carcinoma Metastases: a Case Series and Literature Review

Abstract

The most common sites of metastatic differentiated thyroid cancer are the neck lymph nodes, while distant metastases typically involve the lungs, the bones, and less frequently the brain. Uncommon metastatic sites include the liver, adrenal gland, kidney, pancreas, and skin. The epidemiological aspects of thyroid metastases in rare sites are largely unknown and their identification could have a significant impact on patients management. A mini-series of unusual metastatic sites of thyroid carcinoma is proposed as a contribution to current knowledge on anatomopathological characteristics and clinical outcome. Of the six cases that were assessed, the metastases were the following: skin metastases (2), skin and pancreas metastases (1), renal metastasis (1), adrenal metastasis (1), and liver metastasis (1). In our experience, metastases in rare sites do not always represent a negative prognostic factor for disease outcome. In fact they can occur as single distant lesion and if surgically resectable, their treatment can also lead to local disease remission.

Skin metastasis on the neck: an unusual presentation of recurrence of papillary thyroid carcinoma

“…However, possible mechanisms cannot be explained in previous literature reviews regarding skin metastasis of thyroid cancer after surgery, we can propose that during surgery, thyroid nodules can erupt and contamination with skin may cause metastasis (3,8). In here, these patients were operated previously in different centers, contamination with skin may be the cause of skin metastasis.…”

Unilateral adrenal mass as the sole initial manifestation of differentiated thyroid cancer

“…They are most often diagnosed by other imaging modalities such as positron emission tomography CT/single-photon emission CT 4. Once diagnosed, adrenal metastases from thyroid are managed by adrenalectomy followed by radioiodine therapy 11. In general, prognosis is poor in these patients as they are most often associated with advanced disease, unlike our patient whose initial presentation was as a large isolated adrenal mass with no other evidence of metastasis.…”

Papillary thyroid carcinoma metastatic to the pancreas: Case report

“…RCC has been identified as the most common malignancy (up to 40%), followed by lung, breast, colon, and skin . Furthermore, metastasis of PTC to the pancreas is rare, with only a few cases previously reported . These reports include different PTC variants.…”

“…Most common distant metastatic sites are the lung and bone, with brain ranking as a distant third . PTC metastasis to the pancreas is exceedingly rare …”