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Duan X, Hu T, Cai H, Lin L, Zeng L, Wang H, Cao L, Li X. Radiotherapy for primary thyroid adenoid cystic carcinoma. Open Life Sci 2023; 18:20220547. [PMID: 36910470 PMCID: PMC9993328 DOI: 10.1515/biol-2022-0547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 12/02/2022] [Accepted: 12/14/2022] [Indexed: 03/09/2023] Open
Abstract
Primary thyroid adenoid cystic carcinoma (PTACC) is an extremely rare type of mucin-secreting adenocarcinoma. Currently, it is difficult to diagnose, and it lacks standard treatment protocols. We report the case of a 53-year-old female patient with PTACC who underwent additional intensity-modulated radiotherapy 1 month after surgical treatment with an uneventful course. No invasion or distant metastasis was detected at the 7-month follow-up after radiotherapy, and the prognosis was favorable. In this case, herein, we have summarized the diagnostic features of the disease and proposed that postoperative adjuvant radiotherapy can significantly improve the patient's prognosis. Finally, we further confirmed the important role of radiotherapy in PTACC by reviewing relevant literature, which may provide clinicians with valuable treatment experience.
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Affiliation(s)
- Xiaoyu Duan
- The First Clinical Medical College, Gansu University of Chinese Medicine, Number 35 Ding Xing East Road, Lanzhou, 730000 China.,Department of Radiotherapy, Gansu Provincial Hospital, Number 204 Dong Gang West Road, Lanzhou, 730000 China
| | - Tingting Hu
- Department of Radiotherapy, Gansu Provincial Hospital, Number 204 Dong Gang West Road, Lanzhou, 730000 China
| | - Hongyi Cai
- Department of Radiotherapy, Gansu Provincial Hospital, Number 204 Dong Gang West Road, Lanzhou, 730000 China
| | - Lili Lin
- The First Clinical Medical College, Gansu University of Chinese Medicine, Number 35 Ding Xing East Road, Lanzhou, 730000 China.,Department of Radiotherapy, Gansu Provincial Hospital, Number 204 Dong Gang West Road, Lanzhou, 730000 China
| | - Lu Zeng
- The First Clinical Medical College, Gansu University of Chinese Medicine, Number 35 Ding Xing East Road, Lanzhou, 730000 China.,Department of Radiotherapy, Gansu Provincial Hospital, Number 204 Dong Gang West Road, Lanzhou, 730000 China
| | - Huixia Wang
- The First Clinical Medical College, Gansu University of Chinese Medicine, Number 35 Ding Xing East Road, Lanzhou, 730000 China.,Department of Radiotherapy, Gansu Provincial Hospital, Number 204 Dong Gang West Road, Lanzhou, 730000 China
| | - Lei Cao
- The First Clinical Medical College, Gansu University of Chinese Medicine, Number 35 Ding Xing East Road, Lanzhou, 730000 China.,Department of Radiotherapy, Gansu Provincial Hospital, Number 204 Dong Gang West Road, Lanzhou, 730000 China
| | - Xuxia Li
- The First Clinical Medical College, Gansu University of Chinese Medicine, Number 35 Ding Xing East Road, Lanzhou, 730000 China.,Department of Radiotherapy, Gansu Provincial Hospital, Number 204 Dong Gang West Road, Lanzhou, 730000 China
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Clinicopathological and Molecular Features of Secondary Cancer (Metastasis) to the Thyroid and Advances in Management. Int J Mol Sci 2022; 23:ijms23063242. [PMID: 35328664 PMCID: PMC8955551 DOI: 10.3390/ijms23063242] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 12/19/2022] Open
Abstract
Secondary tumours to the thyroid gland are uncommon and often incidentally discovered on imaging. Symptomatic patients often present with a neck mass. Collision tumours of secondary tumours and primary thyroid neoplasms do occur. Ultrasound-guided fine-needle aspiration, core-needle biopsy, and surgical resection with histological and immunohistochemical analysis are employed to confirm diagnosis as well as for applying molecular studies to identify candidates for targeted therapy. Biopsy at the metastatic site can identify mutations (such as EGFR, K-Ras, VHL) and translocations (such as EML4-ALK fusion) important in planning target therapies. Patients with advanced-stage primary cancers, widespread dissemination, or unknown primary origin often have a poor prognosis. Those with isolated metastasis to the thyroid have better survival outcomes and are more likely to undergo thyroid resection. Systemic therapies, such as chemotherapy and hormonal therapy, are often used as adjuvant treatment post-operatively or in patients with disseminated disease. New targeted therapies, such as tyrosine kinase inhibitors and immune checkpoint inhibitors, have shown success in reported cases. A tailored treatment plan based on primary tumour features, overall cancer burden, and co-morbidities is imperative. To conclude, secondary cancer to the thyroid is uncommon, and awareness of the updates on diagnosis and management is needed.
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