1
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Walker H, Speers J, Fabry M, Kadakia S. Metastatic oropharyngeal squamous cell carcinoma to the thyroid: A case report and review of literature. Am J Otolaryngol 2024; 45:104306. [PMID: 38669814 DOI: 10.1016/j.amjoto.2024.104306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Accepted: 04/14/2024] [Indexed: 04/28/2024]
Abstract
Oral squamous cell carcinoma (OSCC) with metastasis to the thyroid gland is exceedingly rare, with limited documentation within the literature. Between 1984 and 2023, only 40 cases of head and neck squamous cell carcinoma (SCC) with thyroid gland metastasis were described in published literature. Herein, we present a distinctive case of second primary oropharyngeal SCC with metastasis to the thyroid, detected during surveillance positron emission tomography (PET) scanning subsequent to negative margin resection and radiation therapy for SCC originating from the hard palate. The underlying mechanisms overseeing metastasis remain elusive, with hypotheses ranging from lymphatic drainage routes connecting the thyroid gland and retropharyngeal lymph nodes to hematologic dissemination. The management of metastases to the thyroid gland is multifaceted, encompassing approaches ranging from lobectomy and total thyroidectomy to palliative interventions. We present this atypical case alongside supportive pathological and radiological findings and a comprehensive review of this rare clinical entity to offer insight into its diagnosis and management.
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Affiliation(s)
- Hannah Walker
- Department of Surgery, Boonshoft School of Medicine, Wright State University, General Surgery Residency, Dayton, OH, USA.
| | - Jed Speers
- Boonshoft School of Medicine, Wright State University, Dayton, OH, USA.
| | - Milena Fabry
- Kettering Health Dayton Otolaryngology Surgery Residency, Dayton, OH, USA.
| | - Sameep Kadakia
- Department of Surgery, Director and Division Chief of Head and Neck Oncology and Reconstructive Surgery, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA.
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2
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Vandemergel X. Solitary Intrathyroid Metastasis Occurring 23 Years after Resection of Renal Cell Carcinoma. Case Rep Endocrinol 2021; 2021:2735256. [PMID: 34527379 PMCID: PMC8437654 DOI: 10.1155/2021/2735256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/01/2021] [Accepted: 08/20/2021] [Indexed: 11/26/2022] Open
Abstract
A case of solitary intrathyroid metastasis is described in a 60-year-old male patient. He had a history of renal cell carcinoma classified as T1b resected 23 years earlier. A mass was palpable in the right thyroid lobe. Ultrasound showed a hypoechoic polylobular nodule with intense vascularisation in the right lobe. Fine needle aspiration cytology was normal, but thyroidectomy was performed due to mass enlargement, the ultrasound pattern, and the oncological history. Histological examination revealed the presence of an intrathyroid metastasis of renal cell carcinoma. The bone scan and thoracoabdominal CT scan were normal. Postoperative care was uneventful.
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3
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Rodrigo-Gómez L, Pardal-Refoyo JL, Batuecas-Caletrío Á. Prevalencia de tumores metastásicos en la glándula tiroides. Revisión sistemática y metanálisis. REVISTA ORL 2020. [DOI: 10.14201/orl.23207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Introducción y objetivo: Los tumores metastásicos en la glándula tiroides complican el diagnóstico, el tratamiento y el pronóstico del paciente. El objetivo es conocer la prevalencia de las metástasis en la glándula tiroides referida en la literatura médica y los tumores primarios que con más frecuencia metastatizan en la glándula tiroides. Método: Se realizó una revisión bibliográfica sistemática en las bases de datos de PubMed, La Biblioteca Cochrane y Scopus. Los artículos seleccionados se dividieron en dos grupos, series clínicas de pacientes en los que se hallaron metástasis en tiroides (grupo A) y series de hallazgos de metástasis en tiroides en autopsias (grupo B). Se realizó metanálisis de prevalencia para cada grupo de artículos siguiendo el modelo de efectos aleatorios. Resultados: La prevalencia en cada grupo con su índice de confianza al 95% fue 0.00479 (0.002-0.007) para el grupo A y 0.0362 (0.014-0.059) para el grupo B. La prevalencia de metástasis halladas en autopsias fue 7,58 veces mayor que en los estudios clínicos. En el grupo A la edad media fue 60.82 y en el grupo B 57.20. En ambos grupos las metástasis halladas en tiroides fueron más frecuentes en el sexo femenino. La localización del tumor primario fue diferente en ambos grupos, en el grupo A fue el cáncer de riñón y en el grupo B el cáncer de mama. La variabilidad de la prevalencia de metástasis en tiroides en los diferentes artículos de ambos grupos hace que este estudio tuviese una alta heterogeneidad (índice I2 y Q). Los funnel plot de ambos grupos indicaron alto sesgo de publicación. Discusión: La diferente prevalencia entre series clínicas y autopsias puede implicar que la detección de metástasis en tiroides en la clínica está infradiagnosticada. La razón de esto podría ser que las metástasis intratiroideas se presentan de forma asintomática siendo diagnosticadas como hallazgo casual en autopsias. En otras ocasiones se presentan como un nódulo tiroideo años después del tumor primario, lo que condiciona el diagnóstico. Conclusiones: La prevalencia de metástasis en tiroides es superior en las series de autopsias que en series clínicas (hasta 6.67 veces más frecuente en nuestro estudio). Las metástasis intratiroideas probablemente están infradiagnosticadas por cursar sin clínica siendo diagnosticadas como hallazgo casual en autopsias. Los tumores primarios más frecuentes fueron el riñón (series clínicas) y la mama (series de autopsias).
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4
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Ben Saad A, Mhamed SC, Migaou A, Njima M, Achour A, Fahem N, Rouatbi N, Joobeur S. Thyroid metastasis revealing a lung adenocarcinoma. Respir Med Case Rep 2020; 30:101065. [PMID: 32489846 PMCID: PMC7256324 DOI: 10.1016/j.rmcr.2020.101065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 03/23/2020] [Accepted: 04/21/2020] [Indexed: 11/19/2022] Open
Abstract
Thyroid metastasis revealing a primary lung cancer is an extremely rare condition. Only few cases have been reported in the literature. A multidisciplinary approach is essential for the diagnosis. The prognosis is generally poor. We report a case of a 50-year-old man presented with cervical nodules corresponding to a thyroid nodule and lymph nodes. The ultrasonography-guided fine-needle aspiration cytology of the thyroid nodule and a cervical lymphadenopathy concluded to a poorly differentiated adenocarcinoma. Cervical lymphadenopathy biopsy with immunohistochemistry and additional imaging explorations contributed to the diagnosis of a lung adenocarcinoma stage IVB. He died few days after the diagnosis.
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Affiliation(s)
- Ahmed Ben Saad
- Pulmonology Department, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | | | - Asma Migaou
- Pulmonology Department, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Manel Njima
- Department of Pathology, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Asma Achour
- Radiology Department, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Nesrine Fahem
- Pulmonology Department, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Naceur Rouatbi
- Pulmonology Department, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Samah Joobeur
- Pulmonology Department, Fattouma Bourguiba Hospital, Monastir, Tunisia
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5
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Vatsyayan A, Mandlik D, Patel P, Patel P, Sharma N, Joshipura A, Patel M, Odedra P, Dubbal JC, Shah DS, Kanhere SA, Sanghvi KJ, Patel K. Metastasis of squamous cell carcinoma of the head and neck to the thyroid: a single institution's experience with a review of relevant publications. Br J Oral Maxillofac Surg 2019; 57:609-615. [PMID: 31196573 DOI: 10.1016/j.bjoms.2019.05.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 05/18/2019] [Indexed: 12/30/2022]
Abstract
The thyroid gland is a rare site of metastasis, and in particular of those of squamous cell carcinoma (SCC) from the head and neck region. We have reviewed the aetiology, pathogenesis, clinical characteristics, radiological features, immunohistochemical profile, prognosis, and management of metastatic SCC from the head and neck region to the thyroid, and searched current publications on the Medline, Embase, and Cochrane databases using the following keywords: "SCC of thyroid", "secondary SCC of thyroid", and "metastasis to the thyroid", for papers published during the last 33 years (April 1984 to October 2017).We found a total of 19 papers that reported a total of 32 cases that were relevant. Four further cases were discovered as an incidental finding on follow-up positron emission tomographic/computed tomographic scans with magnetic resonance imaging of the head and neck at our hospital, which were confirmed with an ultrasound-guided core needle biopsy followed by immunohistochemical examination. For patients who are doing well, whose disease is controlled at the primary site, and who have no evidence of distant metastatic disease, total thyroidectomy could be considered followed by adjuvant radiation or chemoradiotherapy, depending on the presence of intermediate or high-risk features on pathological examination and previous history of radiation. This may help to control the disease and avoid local morbidity.
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Affiliation(s)
- A Vatsyayan
- Department of Head and Neck Oncology, HCG Cancer Centre, Ahmedabad, Gujarat, 380060, India.
| | - D Mandlik
- Department of Head and Neck Oncology, HCG Cancer Centre, Ahmedabad, Gujarat, 380060, India.
| | - P Patel
- Department of Head and Neck Oncology, HCG Cancer Centre, Ahmedabad, Gujarat, 380060, India.
| | - P Patel
- Department of Head and Neck Oncology, HCG Cancer Centre, Ahmedabad, Gujarat, 380060, India.
| | - N Sharma
- Department of Head and Neck Oncology, HCG Cancer Centre, Ahmedabad, Gujarat, 380060, India.
| | - A Joshipura
- Department of Head and Neck Oncology, HCG Cancer Centre, Ahmedabad, Gujarat, 380060, India.
| | - M Patel
- Department of Head and Neck Oncology, HCG Cancer Centre, Ahmedabad, Gujarat, 380060, India.
| | - P Odedra
- HCG Cancer Centre - Sola, Ahmedabad, Gujarat, India.
| | - J C Dubbal
- Department of Radiology, HCG Cancer Centre, Ahmedabad, India.
| | - D S Shah
- Department of Radiology, HCG Cancer Centre, Ahmedabad, India.
| | | | - K J Sanghvi
- Department of Pathology, Strand Life Sciences, Ahmedabad.
| | - K Patel
- Department of Head and Neck Oncology, HCG Cancer Centre, Ahmedabad, Gujarat, 380060, India.
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6
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Quaglino F, Beccaris M, Iacopini S, Mazza E, Suriani A, Palladin D, Valli M. Solitary Thyroid Metastasis of Clear Cell Renal Carcinoma: Case Report. TUMORI JOURNAL 2018; 95:367-70. [DOI: 10.1177/030089160909500316] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Metastases to the thyroid gland represent a rare event. Malignancies that most frequently metastasize to the thyroid vary between clinical and autopsy studies and by geographic area. In Western countries, renal carcinoma has been recorded as a frequent source of thyroid metastases. We report the case of a 66-year-old man with a thyroid metastasis from clear cell renal carcinoma and discuss its clinical, pathological and imaging features.
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Affiliation(s)
- Francesco Quaglino
- II Divisione Chirurgia Generale ad Indirizzo Oncologico, Ospedale Maria Vittoria, ASL202, Turin, Italy
| | - Moreno Beccaris
- II Divisione Chirurgia Generale ad Indirizzo Oncologico, Ospedale Maria Vittoria, ASL202, Turin, Italy
| | - Sara Iacopini
- II Divisione Chirurgia Generale ad Indirizzo Oncologico, Ospedale Maria Vittoria, ASL202, Turin, Italy
| | - Enrico Mazza
- UO di Endocrinologia e Malattie Metaboliche, Ospedale Maria Vittoria, ASL202, Turin, Italy
| | - Adolfo Suriani
- Servizio Anatomia Patologica, Ospedale Maria Vittoria, ASL202, Turin, Italy
| | - Daniela Palladin
- Servizio Anatomia Patologica, Ospedale Maria Vittoria, ASL202, Turin, Italy
| | - Mario Valli
- II Divisione Chirurgia Generale ad Indirizzo Oncologico, Ospedale Maria Vittoria, ASL202, Turin, Italy
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7
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Dao A, Jabir H, Taleb A, Benchakroun N, Bouchbika Z, Nezha T, Jouhadi H, Sahraoui S, Benider A. Lung adenocarcinoma with thyroid metastasis: a case report. BMC Res Notes 2017; 10:130. [PMID: 28327204 PMCID: PMC5360081 DOI: 10.1186/s13104-017-2449-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 03/11/2017] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The metastases of a primary lung cancer over the thyroid gland are extremely rare. We report on an unusual presentation of thyroid metastasis of lung cancer in order to improve the management of similar cases. CASE PRESENTATION Three years ago, a Moroccan male 59-year-old was admitted for dyspnea, dry cough, and chest pain. He had smoked about 30 cigarette packs a year. Clinical examination revealed a right thyroid nodule. Chest and neck computed tomography (CT) scan showed a proximal left tumor in contact with the pulmonary artery and revealed a suspected nodule in the right lobe of the thyroid with homolateral neck node. Transbronchial biopsy was performed and pathological examination revealed adenocarcinoma of the lung and positive for thyroid transcription factor. Other explorations carried out, such as brain CT, bone scan and abdominal ultrasound were normal. After a repeated negative fine needle aspiration biopsy of the suspected nodule of the right lobe of the thyroid, we performed total thyroidectomy with neck dissection. An anatomopathologic exam revealed a tubulopapillary adenocarcinoma poorly differentiated. An Immunohistochemistry showed positive tumor cells with TTF1 and cytokeratin (CK) 7 but negative cells with thyroglobulin and CK20. Thus, the pulmonary tumor was classified stage IV. Chemotherapy based on the combination of cisplatin and etoposide was conducted along with supportive care. The tumor grew up with brain metastases after three cycles of chemotherapy. Unfortunately, the patient died 2 months after despite brain radiotherapy. CONCLUSION We presented a medical case of a patient with thyroid metastasis resulting from a pulmonary adenocarcinoma which has rapidly evolved to brain metastases. The prognosis was pejorative in our clinical case (5 months after admission).
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Affiliation(s)
- A. Dao
- Centre Hospitalier Universitaire Yalgado Ouedraogo, Ouagadougou, Burkina Faso
| | - H. Jabir
- Centre Mohammed VI pour le Traitement des Cancers, CHU Ibn Rochd, Casablanca, Morocco
| | - A. Taleb
- Centre Mohammed VI pour le Traitement des Cancers, CHU Ibn Rochd, Casablanca, Morocco
| | - N. Benchakroun
- Centre Mohammed VI pour le Traitement des Cancers, CHU Ibn Rochd, Casablanca, Morocco
| | - Z. Bouchbika
- Centre Mohammed VI pour le Traitement des Cancers, CHU Ibn Rochd, Casablanca, Morocco
| | - T. Nezha
- Centre Mohammed VI pour le Traitement des Cancers, CHU Ibn Rochd, Casablanca, Morocco
| | - H. Jouhadi
- Centre Mohammed VI pour le Traitement des Cancers, CHU Ibn Rochd, Casablanca, Morocco
| | - S. Sahraoui
- Centre Mohammed VI pour le Traitement des Cancers, CHU Ibn Rochd, Casablanca, Morocco
| | - A. Benider
- Centre Mohammed VI pour le Traitement des Cancers, CHU Ibn Rochd, Casablanca, Morocco
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8
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Debnam JM, Kwon M, Fornage BD, Krishnamurthy S, Clayman GL, Edeiken-Monroe BS. Sonographic Evaluation of Intrathyroid Metastases. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2017; 36:69-76. [PMID: 27925648 DOI: 10.7863/ultra.16.02033] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 03/30/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES Intrathyroid metastases from extrathyroid primary tumors are rare. Clinical findings may be subtle, but detection of intrathyroid metastases has improved with sonography. The objective of this study was to evaluate the sonographic appearance of intrathyroid metastases. METHODS Patients with thyroid masses with cytopathologic features matching those of an extrathyroid primary tumor were retrospectively identified. The appearances of intrathyroid metastases on sonography were reviewed for the following features: size, margin regularity, echogenicity, echotexture, vascularity on power or color Doppler ultrasonography, and the presence or absence of any associated cervical adenopathy. RESULTS The study included 52 patients. The most frequent primary tumor sites were lung, head and neck, and breast. Intrathyroid metastases presented as a discrete nodule in 34 patients and as diffuse infiltration of the gland in 18 patients. The discrete nodules ranged in size from 1.1 to 5.6 cm (mean ± SD, 2.5 ± 1.2 cm). Thirty-three lesions (63%) had irregular margins, and 19 (37%) had well-defined margins. Most of the lesions were heterogeneously hypoechoic (n = 50, 96%). Vascularity was present in 32 of 50 measured lesions (64%) that were evaluated with Doppler sonography. Cervical adenopathy was present in 37 patients (71%). CONCLUSIONS Intrathyroid metastases have sonographic characteristics similar to those described for both benign and malignant thyroid diseases. In patients with a previous or current extrathyroid malignancy, thyroid nodules or diffuse infiltration of the thyroid gland on sonography should be viewed as a potential intrathyroid metastasis and evaluated via ultrasound-guided fine-needle aspiration regardless of the site of the primary tumor.
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Affiliation(s)
- J Matthew Debnam
- Department of Diagnostic Radiology, Section of Neuroradiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Michael Kwon
- Department of Diagnostic Radiology, Section of Neuroradiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Bruno D Fornage
- Department of Diagnostic Radiology and Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Savitri Krishnamurthy
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Gary L Clayman
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Beth S Edeiken-Monroe
- Department of Diagnostic Radiology, Section of Neuroradiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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9
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Nicosia L, Alessi S, Proh M, Grosso E, Ansarin M, Vingiani A, Pisa E, De Fiori E. Solitary thyroid metastasis from colon cancer: a rare case report. Ecancermedicalscience 2016; 10:696. [PMID: 28101139 PMCID: PMC5215259 DOI: 10.3332/ecancer.2016.696] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Indexed: 11/06/2022] Open
Abstract
Malignant metastases to the thyroid are rare and are even rarer from a colorectal primary. As these metastases are often asymptomatic, they are usually discovered incidentally on imaging performed as follow-up for the primary tumour. In this report, we present a case of metastatic sigmoid adenocarcinoma to the thyroid diagnosed and treated at our institution.
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Affiliation(s)
- L Nicosia
- Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Milano, Italy
| | - S Alessi
- Divisione di Radiologia, Istituto Europeo di Oncologia, Milano, Italy
| | - M Proh
- Divisione di Otorinolaringoiatria e Chirurgia Cervico Facciale Istituto Europeo di Oncologia, Milano, Italy
| | - E Grosso
- Divisione di Otorinolaringoiatria e Chirurgia Cervico Facciale Istituto Europeo di Oncologia, Milano, Italy
| | - M Ansarin
- Divisione di Otorinolaringoiatria e Chirurgia Cervico Facciale Istituto Europeo di Oncologia, Milano, Italy
| | - A Vingiani
- Divisione di Anatomia Patologica, Istituto Europeo di Oncologia, Milano, Italy
| | - E Pisa
- Divisione di Anatomia Patologica, Istituto Europeo di Oncologia, Milano, Italy
| | - E De Fiori
- Divisione di Radiologia, Istituto Europeo di Oncologia, Milano, Italy
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10
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Nixon IJ, Coca-Pelaz A, Kaleva AI, Triantafyllou A, Angelos P, Owen RP, Rinaldo A, Shaha AR, Silver CE, Ferlito A. Metastasis to the Thyroid Gland: A Critical Review. Ann Surg Oncol 2016; 24:1533-1539. [PMID: 27873099 PMCID: PMC5413529 DOI: 10.1245/s10434-016-5683-4] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Indexed: 12/22/2022]
Abstract
Background Metastasis to the thyroid gland from nonthyroid sites is an uncommon clinical presentation in surgical practice. The aim of this review was to assess its incidence management and outcomes. Methods A literature review was performed to identify reports of metastases to the thyroid gland. Both clinical and autopsy series were included. Results Metastases to the gland may be discovered at the time of diagnosis of the primary tumor, after preoperative investigation of a neck mass, or on histologic examination of a thyroidectomy specimen. The most common primary tumors in autopsy studies are from the lung. In clinical series, renal cell carcinoma is most common. For patients with widespread metastases in the setting of an aggressive malignancy, surgery is rarely indicated. However, when patients present with an isolated metastasis diagnosed during follow-up of indolent disease, surgery may achieve control of the central neck and even long-term cure. Other prognosticators include features of the primary tumor, time interval between initial diagnosis and metastasis, and extrathyroid extent of disease. Conclusions In patients with thyroid metastases, communication among clinicians treating the thyroid and the index primary tumor is essential. The setting is complex, and decisions must be made considering the features of the primary tumor, overall burden of metastases, and comorbidities. Careful balancing of these factors influences individualized approaches.
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Affiliation(s)
- Iain J Nixon
- ENT Department, NHS Lothian, Lauriston Building, Lauriston Place, Edinburgh, UK.
| | - Andrés Coca-Pelaz
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Anna I Kaleva
- ENT Department, East and North Hertfordshire Trust, Stevenage, UK
| | - Asterios Triantafyllou
- Oral and Maxillofacial Pathology, School of Dentistry, University of Liverpool, Liverpool, UK.,Department of Cellular Pathology, Liverpool Clinical Laboratories, Liverpool, UK
| | - Peter Angelos
- Department of Surgery and MacLean Center for Clinical Ethics, The University of Chicago Medicine, Chicago, IL, USA
| | - Randall P Owen
- Division of Surgical Oncology, Department of Surgery, Mount Sinai School of Medicine, New York, NY, USA
| | | | - Ashok R Shaha
- Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Carl E Silver
- Department of Surgery, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA
| | - Alfio Ferlito
- International Head and Neck Scientific Group, Padua, Italy
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11
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HooKim K, Gaitor J, Lin O, Reid MD. Secondary tumors involving the thyroid gland: A multi-institutional analysis of 28 cases diagnosed on fine-needle aspiration. Diagn Cytopathol 2015; 43:904-11. [PMID: 26302896 DOI: 10.1002/dc.23331] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 06/22/2015] [Accepted: 08/05/2015] [Indexed: 01/24/2023]
Abstract
BACKGROUND Fine-needle aspiration (FNA) is routinely used to evaluate primary thyroid lesions (PTLs), however, its role in diagnosing secondary thyroid neoplasms (STNs) has not been extensively studied. The goal was to examine the clinical and cytopathologic features of STNs diagnosed on FNA. METHODS The clinico-pathologic features of 28 STNs were analyzed. All PTLs, lymphomas, and locally invasive tumors were excluded. RESULTS There were 28 STNs (0.18% incidence) out of 15,800 thyroid FNAs (12 males, 16 females, 32 - 85 years), all occurring metachronously (3 weeks-20 years, average 78.3 months) comprising 24 (85.7%) metastatic carcinomas (14 [50%] renal; 4 [14.3%] head and neck squamous cell carcinomas, 3 [10.7%] breast, and 1 [3.6%] colorectal, uterine serous carcinoma, and lung adenosquamous carcinoma, respectively), 3 sarcomas (10.7%) and 1 melanoma (3.6%). CONCLUSIONS STNs are rare and diverse tumors which may occur decades after primary malignancy. Renal carcinomas are the most common. Prior history of malignancy, high index of suspicion, and attention to key distinguishing cytologic clues are critical for accurate diagnosis.
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Affiliation(s)
- Kim HooKim
- Department of Pathology, Louisiana State University Health Sciences Center, Shreveport, Los Angeles
| | - Jennifer Gaitor
- Department of Biology, Georgia State University, Atlanta, Georgia
| | - Oscar Lin
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Michelle D Reid
- Department of Pathology, Emory University School of Medicine, Weill Cornell Medical College, Atlanta, Georgia
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12
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Thyroid metastasis from nonsmall cell lung cancer. Case Rep Oncol Med 2014; 2013:208213. [PMID: 24455357 PMCID: PMC3880721 DOI: 10.1155/2013/208213] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Accepted: 12/05/2013] [Indexed: 11/26/2022] Open
Abstract
Background. Thyroid metastases are rare. Clinically, they represent less than 4% of thyroid malignancy in clinical studies. Aim. To assess various presentations and therapy for patients with lung cancer metastatic in the thyroid. Materials and Methods. We report a case of metastatic adenocarcinoma of the lung to the thyroid. We reviewed similar reports through PubmMed search from 1997 until 2013. Case Presentation. A 48-year-old lady was seen in the clinic for an adenocarcinoma of left upper lobe (LUL) of the lung; she received neoadjuvant chemotherapy then LUL lobectomy. After 9 months she presented with diffuse goiter initially believed to be a solitary metastatic lesion as it was positive for adenocarcinoma of lung origin on histopathological exam with TTF-1 positivity. Unfortunately, PET scan showed additional mediastinal lymphadenopathy. Conclusion. The treatment strategy for metastatic thyroid disease is based on a multidisciplinary approach, where thyroidectomy would have been considered in case of a solitary metastatic involvement, but further metastatic workup is mandated to direct further systemic therapy versus palliative radiation therapy.
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13
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Di Stasi V, D'Antonio A, Caleo A, Valvano L. Metastatic renal cell carcinoma to the thyroid gland 24 years after the primary tumour. BMJ Case Rep 2013; 2013:bcr-2012-007569. [PMID: 23355570 DOI: 10.1136/bcr-2012-007569] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Among the metastases to thyroid gland, metastases from renal cell carcinoma (RCC) are not rare and their frequent macroscopic looks are similar to primary thyroid tumours. We report an unusual case of thyroid metastases from renal carcinoma in a 72 -year-old man presented with a 1-year history of choking spells, stridor and dyspnoea. Patient underwent right nephrectomy for RCC, 24 years ago. In the present case, a right hemithyroidectomy was performed for a suspected anaplastic thyroid carcinoma. Histological examination showed a metastases of a clear cell renal carcinoma. Although the RCC showed an indolent biological behaviour, the late thyroid metastases have concurred with a poor prognosis and the patient died 5 months after surgery. The interest of this case lies in the long progression-free survival of the RCC preceded by the diagnosis of the thyroid nodule and the discrepancy between the clinical-radiological and the histological assessment.
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Affiliation(s)
- Vincenza Di Stasi
- Department of Endocrinology, AUO San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
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Squamous cell carcinoma of the thyroid gland: primary or secondary disease? The Journal of Laryngology & Otology 2010; 125:3-9. [PMID: 20950510 DOI: 10.1017/s0022215110002070] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To review the aetiopathogenesis, clinical characteristics, immunohistochemical profile, prognosis and treatment options for primary thyroid squamous cell carcinoma, and to compare it with squamous cell carcinoma metastatic to the thyroid, thus providing the reader with a framework for differentiating primary and secondary disease. METHOD Review of English language literature from the past 25 years. SEARCH STRATEGY A search of the Medline, Embase and Cochrane databases (April 1984 to April 2009) was undertaken to enable a comprehensive review. RESULTS After applying strict criteria for the diagnosis of primary thyroid squamous cell carcinoma, 28 articles were identified reporting 84 cases. When reviewing secondary thyroid squamous cell carcinoma, we only analysed cases of squamous cell carcinoma metastatic to the thyroid gland, and found 28 articles reporting 78 cases. CONCLUSION It is possible to differentiate between primary and secondary thyroid squamous cell carcinoma, on the basis of combined evidence from clinical examination and endoscopic, pathological and radiological evaluation. Such differentiation is important, as the prognosis for primary squamous cell carcinoma is uniformly poor irrespective of treatment, and the most suitable option may be supportive therapy. Treatment for secondary squamous cell carcinoma of the thyroid varies with the site and extent of spread of the primary tumour.
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Rizzo M, Rossi RT, Bonaffini O, Scisca C, Sindoni A, Altavilla G, Benvenga S. Thyroid metastasis of clear cell renal carcinoma: Report of a case. Diagn Cytopathol 2009; 37:759-62. [PMID: 19530097 DOI: 10.1002/dc.21117] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Renal cell carcinoma can recur many years after diagnosis and nephrectomy metastasizing even in uncommon sites, including thyroid gland. Thyroid metastases are extremely rare, the most frequent site of origin are renal tumors. Metastases in thyroid gland appear as painless nodules or masses, "cold" at scintiscan. We report the case of a 67-year-old male patient affected by clear cell renal carcinoma, diagnosed by fine-needle aspiration cytology procedures, and treated with anticancer medical therapy, who noticed after some months a mass in the neck-thyroid region requiring deeper medical investigations. By this way, thyroid fine-needle aspiration cytology reported a lesion made of malignant epithelial cells compatible with metastases of renal carcinoma (clear cell). Clinical and pathological data, together with immunostaining, supported the diagnosis of metastatic clear cell renal carcinoma. The diagnosis of metastatic disease, although difficult clinically and pathologically, should be suspected in patients with a clinical history of cancer, particularly in case of renal cell carcinoma, but fine-needle aspiration cytology can provide the clue for diagnosis.
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Affiliation(s)
- Massimo Rizzo
- Department of Human Pathology, Laboratory of Diagnostic Cytology, Section of Medical Oncology, University of Messina, Messina, Italy.
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Dhouib H, Ben Hmida A, Daoud J, Frikha M, Charfeddine I, Ghorbel A. Un cas de métastase intrathyroïdienne d’un primitif inhabituel. Cancer Radiother 2009; 13:213-5. [DOI: 10.1016/j.canrad.2009.01.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2008] [Revised: 01/06/2009] [Accepted: 01/18/2009] [Indexed: 10/21/2022]
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Abstract
Thyroid hormones (TH) are essential for an adequate growth and development of the kidney. Conversely, the kidney is not only an organ for metabolism and elimination of TH, but also a target organ of some of the iodothyronines' actions. Thyroid dysfunction causes remarkable changes in glomerular and tubular functions and electrolyte and water homeostasis. Hypothyroidism is accompanied by a decrease in glomerular filtration, hyponatremia, and an alteration of the ability for water excretion. Excessive levels of TH generate an increase in glomerular filtration rate and renal plasma flow. Renal disease, in turn, leads to significant changes in thyroid function. The association of different types of glomerulopathies with both hyper- and hypofunction of the thyroid has been reported. Less frequently, tubulointerstitial disease has been associated with functional thyroid disorders. Nephrotic syndrome is accompanied by changes in the concentrations of TH due primarily to loss of protein in the urine. Acute kidney injury and chronic kidney disease are accompanied by notable effects on the hypothalamus-pituitary-thyroid axis. The secretion of pituitary thyrotropin (TSH) is impaired in uremia. Contrary to other non-thyroidal chronic disease, in uraemic patients it is not unusual to observe the sick euthyroid syndrome with low serum triodothyronine (T(3)) without elevation of reverse T(3) (rT(3)). Some authors have reported associations between thyroid cancer and kidney tumors and each of these organs can develop metastases into the other. Finally, data from recent research suggest that TH, especially T(3), can be considered as a marker for survival in patients with kidney disease.
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Affiliation(s)
- P Iglesias
- Department of Endocrinology, Hospital Ramón y Cajal, Carretera de Colmenar, Madrid, Spain.
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Trivedi P, Jain R, Talukdar P, Patel T, Shah M. Rectal adenocarcinoma metastatic to the thyroid gland: report of a case with review of literature. J Gastrointest Cancer 2008; 38:34-7. [PMID: 19065722 DOI: 10.1007/s12029-008-9014-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Priti Trivedi
- Department of Pathology, Research Building, The Gujarat Cancer and Research Institute, New Civil Campus, Room # 412, Asarwa, Ahmedabad, Gujarat 380016, India.
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Rodier JF, Tuech JJ, Wilt M, Lindas P, Bruant-Rodier C. [A locally advanced intrathyroid metastasis of bronchial cancer]. ACTA ACUST UNITED AC 2008; 125:198-203. [PMID: 18755448 DOI: 10.1016/j.aorl.2008.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2007] [Accepted: 07/03/2008] [Indexed: 11/17/2022]
Abstract
PURPOSE To assess the characteristics, the diagnosis and the treatment of intrathyroid metastasis. METHOD The authors report a case of a locally advanced intrathyroid metastasis of a bronchial cancer. RESULTS A 60-year-old woman, treated seven years before for a well-differentiated bronchial adenocarcinoma, developed enlargement of the thyroid gland. Metastatic disease was confirmed by a surgical biopsy. Following incomplete radiochemotherapy, a palliative surgical debulking was performed, associating an isthmolobectomy with a large skin excision and closure with a pectoralis major myocutaneous flap. CONCLUSION Intrathyroid metastases are rare and usually treated by surgery. Surgical management is decided taking into account the type and the kinetics of the primary tumor, the location of the thyroid metastasis, and the extension of the metastatic disease. Except for isolated intrathyroid metastasis of kidney cancer, prognosis remains poor.
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Affiliation(s)
- J-F Rodier
- Département de chirurgie-oncologique, centre de lutte contre le cancer Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, BP 42, 67065 Strasbourg cedex, France.
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JANKOWSKA P, TEOH EM, FISHER C, RHYS EVANS P, NUTTING CM, HARRINGTON KJ. Isolated intrathyroid metastasis from undifferentiated and squamous carcinoma of the head and neck: the case for surgery and re-irradiation. Br J Radiol 2008; 81:e154-61. [DOI: 10.1259/bjr/26919796] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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Cichoń S, Anielski R, Konturek A, Barczyński M, Cichoń W. Metastases to the thyroid gland: seventeen cases operated on in a single clinical center. Langenbecks Arch Surg 2006; 391:581-7. [PMID: 16983577 DOI: 10.1007/s00423-006-0081-1] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2006] [Accepted: 06/06/2006] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS In spite of its rich vasculature, the thyroid gland is rarely the site of metastatic disease. The incidence of such metastases differs depending on the type of the analyzed material. In clinical papers, the incidence is low and, according to various sources, amounts to 2-3% of all malignant tumors of the thyroid. Most commonly, the primary tumor is located in the breast, bronchi, gastrointestinal system, (the colon, esophagus, or stomach) and kidneys. Usually, metastatic thyroid disease is identified upon autopsy, and only sporadic cases are encountered in clinical material. The authors present their experience in treating metastatic disease involving the thyroid gland based on the analysis of their clinical material consisting of patients operated on in a single center. MATERIALS AND METHODS Seventeen patients presented with metastatic tumors of the thyroid. The material was further analyzed retrospectively. The group included four men and 13 women, with the male to female ratio of 1:4.25. The age of the patients ranged from 46 to 76 years, with the mean age amounting to 62+/-9.78 years. Eleven patients were diagnosed based on fine needle aspiration biopsy (FNAB). RESULTS In 13 patients, the primary lesion was a clear cell carcinoma of the kidney, in one breast cancer, in another one uterine carcinoma. In two patients, no primary focus location was established. All the patients were treated surgically. Twelve patients were consistently followed up after the surgery. Of this group, seven are still alive, including five individuals with metastases of renal carcinomas, but without recurrent disease. Five patients died due to disseminated neoplastic disease. No data are available on three patients. The mean follow-up time after thyroid surgery was 3.9 years. The longest followed-up survival time was 11 years. CONCLUSIONS The most commonly clinically detected and treated surgically metastatic lesion of the thyroid gland is clear cell cancer of the kidney. In cases of renal cancer metastases to the thyroid gland, a total thyroidectomy seems to be warranted, although it does not affect the survival time.
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Affiliation(s)
- Stanisław Cichoń
- 3rd Chair of General Surgery, Department of Endocrine Surgery, Jagiellonian University College of Medicine, 37 Prdnicka Street, 31-202 Kraków, Poland
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Lièvre A, Leboulleux S, Boige V, Travagli JP, Dromain C, Elias D, Ducreux M, Malka D. Thyroid metastases from colorectal cancer: the Institut Gustave Roussy experience. Eur J Cancer 2006; 42:1756-9. [PMID: 16762542 DOI: 10.1016/j.ejca.2005.11.042] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2005] [Revised: 11/28/2005] [Accepted: 11/29/2005] [Indexed: 01/12/2023]
Abstract
The prevalence of thyroid metastases in colorectal cancer (CRC) patients is unknown. We retrieved the records of all patients with CRC and pathologically proved thyroid metastasis for the period 1993-2004. Among 5,862 consecutive patients with CRC, 6 (0.1%) were diagnosed with thyroid metastases, a median of 61 months after the diagnosis of primary tumour, and a median of 19 months after the last surgical resection or radiofrequency ablation of other metastases (which were present in all cases). Signs and symptoms, when present (n=3), consisted of cervical pain, cervical adenopathy, goitre, dysphagia, and/or dysphonia. In other cases, the diagnosis was made by positron emission tomography scanning. Thyroidectomy was performed in the 5 patients with isolated thyroid metastases, with cervical lymph node dissection being required in all cases. The only patient treated conservatively because of concomitant liver and lung metastases developed life-threatening dyspnoea, which required emergent tracheal stenting. Median overall survival was 77 months, 58 months, and 12 months after the diagnosis of primary CRC, initial metastases, and thyroid metastasis, respectively. It is concluded that thyroid metastases are rare and occur late in the course of CRC. Thyroidectomy (with cervical lymph node dissection) may result in prevention or improvement of life-threatening symptoms and prolonged survival.
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Affiliation(s)
- Astrid Lièvre
- Department of Medicine, Gastroenterology Unit, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif, France
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Foppiani L, Del Monte P, Marugo A, Arlandini A, Sartini G, Marugo M, Bernasconi D. Heterogeneous malignancy in toxic thyroid nodules. J Endocrinol Invest 2005; 28:294-5. [PMID: 15952416 DOI: 10.1007/bf03345388] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
MESH Headings
- Adenocarcinoma, Clear Cell/diagnostic imaging
- Adenocarcinoma, Clear Cell/pathology
- Adenocarcinoma, Clear Cell/surgery
- Adult
- Aged
- Biopsy, Needle
- Carcinoma, Papillary, Follicular/diagnostic imaging
- Carcinoma, Papillary, Follicular/pathology
- Carcinoma, Papillary, Follicular/surgery
- Female
- Humans
- Male
- Middle Aged
- Radionuclide Imaging
- Thyroid Neoplasms/diagnostic imaging
- Thyroid Neoplasms/pathology
- Thyroid Neoplasms/secondary
- Thyroid Nodule/pathology
- Thyroidectomy
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