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Feng T, Xue M, Sang M, Cui R, Liu X, Liu L. Case report: Thyroid metastasis from hepatocellular carcinoma: a rare case with diffuse solid occupancy and unusual imaging findings. Front Oncol 2024; 14:1360734. [PMID: 39050581 PMCID: PMC11266162 DOI: 10.3389/fonc.2024.1360734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 06/19/2024] [Indexed: 07/27/2024] Open
Abstract
Background Thyroid metastasis represents a rare occurrence, with commonly observed primary tumors originating from renal cell carcinoma, malignant neoplasms of the gastrointestinal tract, lungs, and breast. However, the metastasis of hepatocellular carcinoma to the thyroid gland remains infrequent. Previous investigations have consistently demonstrated an unfavorable prognosis for patients with malignancies that have metastasized to the thyroid. In this context, we present a noteworthy case of thyroid metastasis from hepatocellular carcinoma (HCC), characterized by a distinct ultrasonographic manifestation of diffuse thyroid lesion, deviating from the previously documented imaging presentations of thyroid metastases in HCC. Case presentation A 62-year-old Chinese female patient was diagnosed with hepatocellular liver cancer in 2019, following which she underwent a radical hepatic resection. Pathological examination revealed HCC located in the right lobe (stage T3bN0M0 IIIB). No additional interventions were administered subsequent to the surgery. After a span of 15 months, the patient presented with dyspnea. Ultrasonographic findings showed diffuse solid infiltration within the thyroid gland, along with tumor thrombi in both internal jugular veins. Computed tomography (CT) scans demonstrated malignant thyroid lesions infiltrating the retropharyngeal space, prevertebral space, and esophageal wall. The subsequent pathology report from the puncture biopsy confirmed the malignant nature of the tumor, and immunohistochemical analysis definitively established its hepatic origin. Conclusions Patients with a history of HCC should be subjected to long-term monitoring and habitual thyroid ultrasonography. Newly detected thyroid nodules in such patients should be immediately regarded suspect for potential metastatic disease. Even when a nodule doesn't exhibit malignant characteristics on ultrasound, FNAB should be administered promptly to elucidate the pathological condition. Larger, swiftly multiplying thyroid masses should warrant an immediate CNB. The identification of thyroid metastases, particularly when coupled with peripheral tissue invasion, typically signifies a bleak prognosis.
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Affiliation(s)
- Tinghua Feng
- Department of Ultrasound, Shanxi Bethune Hospital affiliated to Shanxi Medical University, Taiyuan, China
| | - Menghua Xue
- Department of Ultrasound, Shanxi Bethune Hospital affiliated to Shanxi Medical University, Taiyuan, China
| | - Miaoyu Sang
- Department of Endocrinology, The Third People’s Hospital of Datong, Datong, China
| | - Rongrong Cui
- Department of Ultrasound, Shanxi Bethune Hospital affiliated to Shanxi Medical University, Taiyuan, China
| | - Xiaofang Liu
- Department of Ultrasound, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Liping Liu
- Department of Interventional Ultrasound, The First Hospital of Shanxi Medical University, Taiyuan, China
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Maestri M, Cicerone O, Messina A, Gallotti A, Corallo S, Mauramati S, Canzi P, Fiandrino G, Paulli M, Vanoli A. Pink-on-pink: hepatocellular carcinoma metastatic to oncocytic carcinoma of the thyroid. Pathologica 2024; 116:158-162. [PMID: 38979589 DOI: 10.32074/1591-951x-922] [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: 09/23/2023] [Accepted: 05/25/2024] [Indexed: 07/10/2024] Open
Abstract
Hepatocellular carcinoma typically metastasizes within the liver and may involve extrahepatic sites such as the lungs, adrenal glands, and bones at advanced stages. However, hepatocellular carcinoma metastasis to the thyroid is very uncommon and tumor-to-tumor metastasis from a hepatocellular cancer to a thyroid neoplasm is extremely rare. In this report, we present a case of a 70-year-old man with a hepatocellular carcinoma metastasizing to oncocytic thyroid carcinoma, emphasizing the importance of clinical history and of a multidisciplinary approach, as well as the usefulness of site-specific immunohistochemical markers, in diagnosing and managing cases of Rosai's metastasis, especially when donor and recipient neoplasms share similar histologic features.
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Affiliation(s)
- Marcello Maestri
- Unit of General Surgery 1, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Alessia Messina
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
- Unit of Anatomic Pathology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Anna Gallotti
- Institute of Radiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Salvatore Corallo
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Simone Mauramati
- Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Pietro Canzi
- Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Giacomo Fiandrino
- Unit of Anatomic Pathology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marco Paulli
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
- Unit of Anatomic Pathology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Alessandro Vanoli
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
- Unit of Anatomic Pathology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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Tang J, Zhang LJ, Kang M, Huang R, Shu HY, Wei H, Zou J, Pan YC, Ling Q, Shao Y. AFP and CA-125 as an accurate risk factor to predict eye metastasis in hypertension patients with liver carcinoma: A STROBE-compliant article. Front Genet 2022; 13:1010903. [PMID: 36199582 PMCID: PMC9527270 DOI: 10.3389/fgene.2022.1010903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 08/30/2022] [Indexed: 11/28/2022] Open
Abstract
Purpose: In this study, we analyzed the differences between hypertension patients with ocular metastasis of liver cancer and those with metastases to other sites, the correlation between history of HBV and liver cancer metastasis, and independent risk factors for ocular metastasis. Methods: We used treatment records from 488 patients with metastases of primary liver cancer from August 2001 to May 2015, divided into two groups based on metastatic sites: OM (ocular metastasis) and NOM (non-ocular, other sites of metastasis) groups. The Student’s t-test and Chi-square test were used to assess the significance of differences between the groups and define the relationship between history of HBV and ocular metastasis of liver cancer. Binary logistic regression analysis was used to identify indicators of ocular metastasis of liver cancer and receiver operating curve (ROC) analyses to estimate their diagnostic value. Results: No significant differences in sex, age, tumor stage, pathological type, or treatment were identified between the OM and NOM groups, while the prevalence of HBV was higher in the former than that in latter. Binary logistic regression demonstrated that AFP and CA-125 were independent indicators of liver metastasis (both p < 0.001). ROC curve analyses generated cut-off values for AFP and CA-125 of 957.2 ng/ml and 114.25 U/ml, respectively, with corresponding AUC values of 0.739 and 0.810. The specificity of the combination of AFP and CA-125 was higher than either factor separately. Discussion: To explore the diagnostic value of AFP and CA125 in predicting the development of ocular metastases of hypertensive patients with liver cancer, which will help us to diagnose the occurrence and development of the disease more accurately and make the best clinical diagnosis and treatment measures.
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Affiliation(s)
- Jing Tang
- Department of Oncology, The First Affiliated Hospital of Nanchang University, Jiangxi Center of National Ocular Disease Clinical Research Center, Nanchang, Jiangxi, China
| | - Li-Juan Zhang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Center of National Ocular Disease Clinical Research Center, Nanchang, Jiangxi, China
| | - Min Kang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Center of National Ocular Disease Clinical Research Center, Nanchang, Jiangxi, China
| | - Rong Huang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Center of National Ocular Disease Clinical Research Center, Nanchang, Jiangxi, China
| | - Hui-Ye Shu
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Center of National Ocular Disease Clinical Research Center, Nanchang, Jiangxi, China
| | - Hong Wei
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Center of National Ocular Disease Clinical Research Center, Nanchang, Jiangxi, China
| | - Jie Zou
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Center of National Ocular Disease Clinical Research Center, Nanchang, Jiangxi, China
| | - Yi-Cong Pan
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Center of National Ocular Disease Clinical Research Center, Nanchang, Jiangxi, China
| | - Qian Ling
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Center of National Ocular Disease Clinical Research Center, Nanchang, Jiangxi, China
| | - Yi Shao
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Center of National Ocular Disease Clinical Research Center, Nanchang, Jiangxi, China
- *Correspondence: Yi Shao,
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Park JY, Yi SY, Kwon T, Baek SH, Kim SJ, Kwon KE, Choi J. Sonographic diagnosis of thyroid metastasis from hepatocellular carcinoma. JOURNAL OF CLINICAL ULTRASOUND : JCU 2019; 47:44-46. [PMID: 30393879 DOI: 10.1002/jcu.22652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 08/27/2018] [Accepted: 09/24/2018] [Indexed: 06/08/2023]
Abstract
Metastasis to the thyroid is very rare in hepatocellular carcinoma (HCC) and only a few cases have been reported. Herein, we report a rare case of metastatic HCC to the thyroid in a 63-year-old man and discuss the various radiologic findings. Computed tomography (CT) revealed a heterogeneous enhancing mass that had invaded the thyroid cartilage in the left upper thyroid, compressing the airway. Ultrasonography (US) showed a heterogeneous hypoechoic mass with increased vascularity in the peripheral portion. The mass showed focal intense uptake on positron emission tomography-computed tomography (PET-CT). The patient underwent US-guided core needle biopsy and the final diagnosis was metastatic HCC.
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Affiliation(s)
- Ji Yeon Park
- Department of Radiology, Myongji Hospital, Hanyang University Medical Center, Goyang-si, Republic of Korea
| | - Seong Yoon Yi
- Division of Hematology-Oncology, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Taejung Kwon
- Department of Pathology, Myongji Hospital, Hanyang University Medical Center, Goyang-si, Republic of Korea
| | - Soo Heui Baek
- Department of Radiology, Myongji Hospital, Hanyang University Medical Center, Goyang-si, Republic of Korea
| | - Seon-Jeong Kim
- Department of Radiology, Myongji Hospital, Hanyang University Medical Center, Goyang-si, Republic of Korea
| | - Ki Eon Kwon
- Department of Radiology, Myongji Hospital, Hanyang University Medical Center, Goyang-si, Republic of Korea
| | - Jiyoun Choi
- Department of Nuclear medicine, Myongji Hospital, Hanyang University Medical Center, Goyang-si, Republic of Korea
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Kumar A, Gupta S, Jakhmola C. Amenorrhea along with renal and thyroid metastasis: Unusual presentation of pancreatic adenocarcinoma. Med J Armed Forces India 2018; 74:400-403. [PMID: 30449933 PMCID: PMC6224655 DOI: 10.1016/j.mjafi.2017.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 09/25/2017] [Indexed: 02/07/2023] Open
Affiliation(s)
- Ameet Kumar
- Classified Specialist (Surgery) & GI Surgeon, Command Hospital Air Force, Bangalore 560007, India
- Corresponding author.
| | - Suhani Gupta
- Assistant Professor (Surgery), All India Institute of Medical Sciences, New Delhi, India
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Abbas A, Medvedev S, Shores N, Bazzano L, Dehal A, Hutchings J, Balart L. Epidemiology of metastatic hepatocellular carcinoma, a nationwide perspective. Dig Dis Sci 2014; 59:2813-20. [PMID: 24903653 DOI: 10.1007/s10620-014-3229-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Accepted: 05/26/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) is the most common primary tumor of the liver. AIMS The aim of this study was to describe the prevalence, trends, and predictors of metastatic HCC on a national scale. METHODS We used two nationwide datasets for our study: the University Health Consortium (UHC) and the Nationwide Inpatient Sample (NIS) databases. We included adults with a primary diagnosis of HCC from 2000 to 2011. We collected information regarding demographics, insurance, HCC risk factors, liver decompensation, and the sites and frequencies of metastases. Multivariable regression analysis was used to examine predictors of metastatic HCC. Trend analysis was performed to examine the change in metastatic HCC prevalence over time. RESULTS We included 25,671 and 26,054 HCC patients from UHC and NIS, respectively. Prevalence of metastatic HCC was 18 % with lung being the most frequent site (31 %). Compared with Caucasian, African American ethnicity was an independent predictor of metastasis in both the NIS [OR 1.13 (1.02-1.25)] and UHC [OR 1.4 (1.3-1.6)] databases. Lack of long-term insurance was associated with significantly higher prevalence of metastasis in both the NIS [OR 1.6 (1.4-1.9)] and UHC [OR 1.9 (1.6-2.2)] databases. There has been an increased prevalence of metastatic HCC over the last decade with an annual percentage change of +1.25 and +1.60 % (p = 0.03 and p = 0.08) for the NIS and UHC databases, respectively. CONCLUSIONS Metastasis is not rare among HCC patients and is rising in prevalence over the last decade. Lungs were the most common metastatic site. Ethnicity and insurance status are independent predictors of metastasis.
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Affiliation(s)
- Ali Abbas
- Department of Internal Medicine, Shands Hospital, University of Florida, 1600 SW Archer Road, PO BOX 100277, Gainesville, FL, 32610, USA,
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Souza e Silva ISD, Gonzáles AM, Linhares MM, Salzedas Neto A, Szejnfeld D, D'Ippolito G, Lopes Filho GDJ, Lanzoni VP, Matos CA. Long-term follow-up after resection of thyroid metastases from hepatocellular carcinoma in noncirrhotic liver. ACTA ACUST UNITED AC 2014; 57:327-31. [PMID: 23828439 DOI: 10.1590/s0004-27302013000400009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Accepted: 02/18/2013] [Indexed: 01/11/2023]
Abstract
Thyroid metastasis from hepatocellular carcinoma (HCC) is rare, and has poor prognosis. We report the case of a 62-year-old woman seen at our clinic because of the occurrence of a slightly painful abdominal mass. At that time, alpha-fetoprotein concentration was very high, reaching 49,831.7 ng/mL. Abdominal ultrasound showed a heterogeneous mass in segment IV of the liver, which was diagnosed as HCC upon MRI. The patient underwent surgical resection and histological analysis of the specimen confirmed HCC. Metastases to the thyroid were detected 17 months after liver resection. Although the presence of metastases indicates advanced disease, thyroidectomy was performed, since no other distant metastases were detected. In fact, the patient is doing well 3 years after thyroidectomy and regular imaging exams showed no tumor recurrence. Current alpha-fetoprotein concentration is 8 ng/mL. In conclusion, thyroid metastasis from HCC is uncommon and short-term survival is expected. However, surgical resection should be encouraged, especially in the case of solitary metastases.
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8
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Metastasis of dermatofibrosarcoma from the abdominal wall to the thyroid gland: case report. Case Rep Med 2012; 2012:659654. [PMID: 23150733 PMCID: PMC3488409 DOI: 10.1155/2012/659654] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Accepted: 09/29/2012] [Indexed: 12/25/2022] Open
Abstract
Metastases in the thyroid gland are very rare. Even the rarer are sarcoma metastases. A 52-year-old woman was referred to our department for evaluation of a nodule in the right lobe of the thyroid gland. She had a history dermatosarcoma of the abdominal wall with known metastasis in the lung. Clinically she had neck pain and worsened swallowing. Objective assessment (ultrasound, computed tomography, and magnetic resonance) indicated a voluminous right lobe nodule with mechanical syndrome, and a fine-needle aspiration biopsy revealed a very suspicious malignant finding. After surgery, the diagnosis was metastasis of dermatofibrosarcoma protuberans. Subsequent treatment was radio- and chemotherapy.
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Chung AY, Tran TB, Brumund KT, Weisman RA, Bouvet M. Metastases to the thyroid: a review of the literature from the last decade. Thyroid 2012; 22:258-68. [PMID: 22313412 DOI: 10.1089/thy.2010.0154] [Citation(s) in RCA: 173] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Although clinically evident metastases of nonthyroid malignancies (NTMs) to the thyroid gland are uncommon, it is important to suspect them in patients who present with a new thyroid mass and a history, however far back, of prior malignancy. In fact, metastases from NTMs to the thyroid gland have been reported in 1.4%-3% of all patients who have surgery for suspected cancer in the thyroid gland. Here we review the literature over the last decade regarding this topic. SUMMARY Based on recent literature, the most common NTMs that metastasize to the thyroid gland are renal cell (48.1%), colorectal (10.4%), lung (8.3%), and breast carcinoma (7.8%), and sarcoma (4.0%). Metastases of NTMs to the thyroid are more common in women than men (female to male ratio=1.4 to 1) and in nodular thyroid glands (44.2%). The mean and median intervals between diagnosing NTMs and their metastases to thyroid gland are 69.9 and 53 months, respectively. In 20% of cases the diagnosis of the NTM and its metastases to the thyroid was synchronous. Recent reports indicate that there is a higher frequency of sarcoma metastasizing to the thyroid gland than reported in prior years. Fine-needle aspiration biopsy (FNAB) of thyroid masses is useful in diagnosis of thyroid metastases. However, this requires information about the NTM so that the proper antibodies can be used for immunohistochemical analysis; therefore it is of lesser utility if the NTM is occult. In patients with preexisting thyroid pathology the FNAB diagnosis can be more difficult due to more than one lesion being present. CONCLUSIONS It is important to keep in mind that the thyroid gland can be a site of metastases for a variety of tumors when evaluating a thyroid nodule, especially in a patient with a prior history of malignancy. In patients with thyroid lesions and a history of malignant disease, regardless of time elapsed since the initial diagnosis of the primary neoplasm, disease recurrence or progression of malignancy must be considered until proven otherwise.
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Affiliation(s)
- Alice Y Chung
- Department of Surgery, University of California San Diego, La Jolla, California 92093, USA
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Park MH, Cho JS, Lee JS, Kim HK, Yoon JH. Thyroid gland metastasis arising from primary liver cholangiocarcinoma: The first case report involving surgical operation. Int J Surg Case Rep 2011; 3:78-81. [PMID: 22288052 DOI: 10.1016/j.ijscr.2011.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2011] [Revised: 10/29/2011] [Accepted: 11/01/2011] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION A primary cancer causing thyroid metastasis is extremely rare. In western countries, the most common primary tumors causing thyroid metastases include kidney, lung, breast, and gastrointestinal cancers. In contrast, breast is the most common primary site, followed by kidney, colon, and lung cancers in Korea. To the best of our knowledge, surgically confirmed thyroid metastasis from cholangiocarcinoma has not been reported. Herein, we report the first case of thyroid metastasis secondary to cholangiocarcinoma on which surgery was performed. PRESENTATION OF CASE A 55-year-old man was diagnosed with hepatic malignancy in December 2008. He subsequently received 2 cycles of transarterial chemoembolization and 4 cycles of radio-frequency ablation between 2008 and 2010. At follow-up in January 2011, brain metastasis was identified in the right parietal area secondary to cholangiocarcinoma. In April 2011, the patient was found to have palpable masses on the left thyroid and lateral neck. The patient subsequently underwent total thyroidectomy followed by left radical neck dissection. Intraoperatively, an ill-defined mass measuring 6.0 cm was found infiltrating the subcutaneous tissue into the prevertebral fascia. Microscopic and immunohistochemical findings confirmed that the thyroid masses and lymph nodes were metastatic cholangiocarcinoma. DISCUSSION Positive immunohistochemical staining for cytokeratin 7, cytokeratin 19, and AFP and negative results for TG, TTF-1, and cytokeratin 20 can be definitely helpful in arriving at a correct diagnosis. CONCLUSION To the best of our knowledge, this is the first case report on surgically resected thyroid and lateral neck metastases secondary to cholangiocarcinoma.
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Affiliation(s)
- Min Ho Park
- Department of Surgery, Chonnam National University College of Medicine, Gwangju, Republic of Korea
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Sung TY, Lee SR, Lee JH, Lee YM, Lee AL, Hwang DW, Yoon JH, Gong G, Hong SJ, Park KM. Hepatocellular carcinoma eats medullary thyroid carcinoma, a case of tumor-in-tumor metastasis. Endocr J 2011; 58:801-5. [PMID: 21757828 DOI: 10.1507/endocrj.ej11-0052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Carcinoma metastasis to the thyroid is uncommon, but may be increasing. We describe here a patient with a metastasis of hepatocellular carcinoma (HCC) presenting within a medullary thyroid carcinoma (MTC). The thyroid tumor was detected synchronously with the hepatic lesion by FDG-PET imaging, and HCC metastasis within MTC was confirmed by histological analysis of the thyroid gland.
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Affiliation(s)
- Tae-Yon Sung
- Division of Endocrine Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Songpa-Gu, Seoul, Korea
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Toshima T, Taketomi A, Shirabe K, Takeishi K, Motomura T, Mano Y, Morita K, Fukuhara T, Sugimachi K, Maruoka Y, Abe K, Tajima T, Maehara Y. Solitary Asymptomatic Thyroid Metastasis from Hepatocellular Carcinoma Detected by FDG-PET/CT. Case Rep Gastroenterol 2010; 4:279-85. [PMID: 21383951 PMCID: PMC3047758 DOI: 10.1159/000318858] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Thyroid metastases from hepatocellular carcinoma (HCC) seldom occur and are often difficult to diagnose because of their asymptomatic clinical course. We evaluated a very rare case of solitary thyroid metastasis from HCC that showed high uptake of fluorine-18 fluorodeoxyglucose (FDG), when imaged using fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT). The patient was a 74-year-old man and presented with a remarkably elevated des-gamma-carboxy prothrombin level of 1,157 mAU/ml 22 months after hepatic lobectomy. FDG-PET/CT imaging revealed a hypodense tumor with high FDG uptake, with a maximum standardized uptake value of 5.2 in the thyroid left lobe. Solitary thyroid metastasis from HCC was suspected and subsequent fine needle aspiration did indeed reveal HCC. The patient received left thyroidectomy with left regional lymph node dissection. Two months after left thyroidectomy, contrast-enhanced computed tomography showed local recurrence, and the patient received ongoing radiotherapy treatment. To our knowledge, the present study is the first to demonstrate the feasibility of FDG-PET/CT in the diagnosis and management of clinically diagnosed, asymptomatic, solitary thyroid metastasis from HCC.
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Affiliation(s)
- Takeo Toshima
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Butte JM, Marín L, Meneses M, De la Fuente H, Pruzzo R, Redondo F, Parada H, Amaral H, Waugh E. Thyroid metastases from gallbladder cancer. J Gastrointest Surg 2009; 13:1389-91. [PMID: 19023633 DOI: 10.1007/s11605-008-0743-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2008] [Accepted: 10/28/2008] [Indexed: 01/31/2023]
Abstract
BACKGROUND Gallbladder cancer is an aggressive malignancy and radical resection is the only curative therapy available. Metastatic disease in the thyroid is rarely seen; however, different studies have confirmed that the most common primary tumor source is the kidney. CASE REPORT Thyroid metastases from tumors originating in the gastrointestinal tract have been reported. We report a patient with gallbladder cancer (T2N1M0) treated with radical resection and postoperative chemoradiation who developed thyroid metastases.
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Affiliation(s)
- Jean M Butte
- Instituto Oncológico Fundación Arturo López Pérez, Rancagua, 878, Santiago, Chile
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