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Fan M, Zhang C, Liu Y, Zhao J. Malignant fibrous histiocytoma of the maxillary sinus coexisting with thyroid carcinoma: A case report. Asian J Surg 2024; 47:1934-1935. [PMID: 38218641 DOI: 10.1016/j.asjsur.2023.12.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 12/25/2023] [Indexed: 01/15/2024] Open
Affiliation(s)
- Min Fan
- Department of Radiology, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University. Luzhou, Sichuan, 646000, PR China
| | - Chunyin Zhang
- Department of Nuclear Medicine, The Affiliated Hospital, Southwest Medical University Luzhou, Sichuan, 646000, PR China
| | - Yong Liu
- Department of Magnetic Resonance Imaging, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University. Luzhou, Sichuan, 646000, PR China
| | - Jie Zhao
- Department of Magnetic Resonance Imaging, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University. Luzhou, Sichuan, 646000, PR China.
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2
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Meng W, Guo Q, Tang G, Han G, Ma G, Zhang Q, Li R, Liu S, Yu G. Thyroid Metastases from Triple-Negative Breast Cancer with High PD-L1 Expression - A Rare Presentation. Onco Targets Ther 2024; 17:103-107. [PMID: 38375327 PMCID: PMC10875622 DOI: 10.2147/ott.s428745] [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: 08/08/2023] [Accepted: 11/27/2023] [Indexed: 02/21/2024] Open
Abstract
Thyroid metastases secondary to triple-negative breast cancer are sporadic. Diagnosis usually requires fine needle aspiration biopsy (FNAB) and immunohistochemistry. There are no treatment guidelines for this type of cancer, and to date, reports of chemotherapy combined with immunotherapy in thyroid metastases are very rare. Here, we first report the effectiveness of anti-PD-1 inhibitor in combination with chemotherapy for the treatment of metastatic thyroid cancer secondary to advanced triple-negative breast cancer with high expression of programmed cell death ligand 1 (PD-L1). Following six cycles of albumin paclitaxel (400mg d1/21 days) plus PD-1 antibody inhibitor (Sindilizumab 200mg d1/21 days), the patient experienced significant relief of neck swelling and obstructive feeding, both the thyroid metastases and the right breast lesion regressed completely following six cycles of treatment. Chemotherapy combined with immunotherapy may provide a new direction for unresectable advanced thyroid metastases.
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Affiliation(s)
- Wenjuan Meng
- Department of Oncology, Weifang People’s Hospital (The First Affiliated Hospital of Shandong Second Medical University), Weifang, Shandong, 261041, People’s Republic of China
| | - Qingxia Guo
- Department of Oncology, Junan People’s Hospital, Junan, Shandong, 276600, People’s Republic of China
| | - Gaoyan Tang
- Department of Oncology, Weifang People’s Hospital (The First Affiliated Hospital of Shandong Second Medical University), Weifang, Shandong, 261041, People’s Republic of China
| | - Guiyan Han
- Department of Pathology, Weifang People’s Hospital (The First Affiliated Hospital of Shandong Second Medical University), Weifang, Shandong, 261041, People’s Republic of China
| | - Guikai Ma
- Department of Oncology, Weifang People’s Hospital (The First Affiliated Hospital of Shandong Second Medical University), Weifang, Shandong, 261041, People’s Republic of China
| | - Qingyun Zhang
- Department of Oncology, Weifang People’s Hospital (The First Affiliated Hospital of Shandong Second Medical University), Weifang, Shandong, 261041, People’s Republic of China
| | - Rui Li
- Department of Oncology, Weifang People’s Hospital (The First Affiliated Hospital of Shandong Second Medical University), Weifang, Shandong, 261041, People’s Republic of China
| | - Shuzhen Liu
- Department of Oncology, Weifang People’s Hospital (The First Affiliated Hospital of Shandong Second Medical University), Weifang, Shandong, 261041, People’s Republic of China
| | - Guohua Yu
- Department of Oncology, Weifang People’s Hospital (The First Affiliated Hospital of Shandong Second Medical University), Weifang, Shandong, 261041, People’s Republic of China
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Patrizio A, Ferrari SM, Stoppini G, Palmisano E, Elia G, Ragusa F, Paparo SR, Balestri E, Mazzi V, Botrini C, Proietti A, Famà F, Benvenga S, Antonelli A, Fallahi P. Thyroid Metastasis from Primary Breast Cancer. J Clin Med 2023; 12:jcm12072709. [PMID: 37048792 PMCID: PMC10095414 DOI: 10.3390/jcm12072709] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/15/2023] [Accepted: 04/03/2023] [Indexed: 04/08/2023] Open
Abstract
Breast cancer (BC), the most commonly diagnosed malignancy, frequently metastasizes to the bone, lungs, brain and liver at advanced stages, whereas the thyroid gland represents a rare target site for secondary disease. We examined the most recent literature about thyroid metastasis (TM) from BC after we encountered a peculiar case of a 71-year-old woman who developed sudden dysphagia, severe hypothyroidism and hypoparathyroidism due to TM 18 years after the diagnosis of her primary cancer. Based on published data, the prevalence of TM in BC ranges from 3% to 34%, with a median onset time of 48.2 months, although longer time intervals are not infrequent. TM negatively impacts the prognosis of these patients, however thyroid surgery can limit the local disease burden. Therefore, we suggest that clinicians involved in the follow-up care of BC patients should consider a differential diagnosis of secondary thyroid malignancy when incidental lesions are diagnosed during radiological evaluations or local symptoms affect the cervical region, even many years after the diagnosis of the primary cancer.
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Affiliation(s)
- Armando Patrizio
- Department of Emergency Medicine, Azienda Ospedaliero-Universitaria Pisana, 56124 Pisa, Italy
| | | | - Giulio Stoppini
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Elena Palmisano
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Giusy Elia
- Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, 56126 Pisa, Italy
| | - Francesca Ragusa
- Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, 56126 Pisa, Italy
| | - Sabrina Rosaria Paparo
- Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, 56126 Pisa, Italy
| | - Eugenia Balestri
- Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, 56126 Pisa, Italy
| | - Valeria Mazzi
- Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, 56126 Pisa, Italy
| | - Chiara Botrini
- Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, 56126 Pisa, Italy
| | - Agnese Proietti
- Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, 56126 Pisa, Italy
| | - Fausto Famà
- Department of Human Pathology in Adulthood and Childhood “G. Barresi”, University Hospital “G. Martino”, 98125 Messina, Italy
| | - Salvatore Benvenga
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
- Master Program on Childhood, Adolescent and Women’s Endocrine Health, University of Messina, 98125 Messina, Italy
- Interdepartmental Program of Molecular and Clinical Endocrinology and Women’s Endocrine Health, Azienda Ospedaliera Universitaria Policlinico “G. Martino”, 98125 Messina, Italy
| | - Alessandro Antonelli
- Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, 56126 Pisa, Italy
| | - Poupak Fallahi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
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Zhang Y, Lin B, Lu KN, Teng YP, Zhou TH, Da JY, Wu F, Pan G, Luo DC. Neuroendocrine neoplasm with metastasis to the thyroid: a case report and literature review. Front Oncol 2023; 13:1024908. [PMID: 37188185 PMCID: PMC10179498 DOI: 10.3389/fonc.2023.1024908] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 04/12/2023] [Indexed: 05/17/2023] Open
Abstract
Thyroid cancer can be divided into two types according to its cellular origin, i.e., malignant tumors originating from thyroid cells and cancers that metastasize to the thyroid from other sites, the latter of which are, clinically rare. This article reports the diagnosis and treatment of a rectal neuroendocrine neoplasm metastasis to the thyroid. No similar cases have been reported before. This case suggests that when evaluating thyroid tumors, clinicians should not only carefully identify the clinical features of the tumor but also pay special attention to the patient's history of tumors, especially neuroendocrine neoplasms. For definite secondary thyroid malignancies, neck surgery is feasible if the thyroid is the only site of metastasis; otherwise, the subsequent diagnosis and treatment plan should be determined after a comprehensive evaluation of the primary tumor and patient's general condition.
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Affiliation(s)
- Yu Zhang
- Department of Oncological Surgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Bei Lin
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Kai-ning Lu
- Department of Breast Surgery, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yue-ping Teng
- Department of Operating Room, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Tian-han Zhou
- Department of General Surgery, Zhejiang Provincial Hospital of Chinese Medicine, Hangzhou, Zhejiang, China
| | - Jia-yang Da
- Department of Dermatology, Third People's Hospital of Hangzhou, Hangzhou, China
| | - Fan Wu
- Department of Oncological Surgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Gang Pan
- Department of Oncological Surgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Ding-cun Luo
- Department of Oncological Surgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
- *Correspondence: Ding-cun Luo,
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Wen W, Jiang H, Wen HY, Peng YL. Metastasis to the thyroid gland from primary breast cancer presenting as diffuse goiter: A case report and review of literature. World J Clin Cases 2022; 10:1106-1115. [PMID: 35127926 PMCID: PMC8790461 DOI: 10.12998/wjcc.v10.i3.1106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 10/28/2021] [Accepted: 12/23/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Metastasis to the thyroid gland (TM) from primary breast cancer is uncommon and usually presents as thyroid nodules; however, diffuse goiter without thyroid nodules is the first sign of TM in rare cases. Skip metastases (SMs) to the lymph nodes in breast cancer, defined as discontiguous higher-level metastases in the absence of lower levels of contiguous metastases, have been reported in the contralateral cervical area of the primary tumor site in rare cases.
CASE SUMMARY A 49-year-old previously healthy Chinese woman was diagnosed with right lateral invasive ductal carcinoma and underwent neoadjuvant chemotherapy treatment and bilateral mastectomy with axillary lymph node dissection. No malignancy of the left breast or axillary or distant metastases were identified preoperatively. However, enlarged left cervical lymph nodes were detected 36 mo after surgery, and rapidly enlarging thyroid glands without nodules were detected 42 mo after surgery. Fine-needle aspiration cytology was performed on the left cervical lymph nodes and left lobe of the thyroid, which were both revealed to contain metastases from the primary breast cancer. Additionally, the immunostaining profiles changed in the process of metastases. The patient was discharged with the NP (vinorelbine and cisplatin) regimen for subsequent treatment, and stable disease was determined when the curative effect was evaluated.
CONCLUSION Diffuse goiter may be the first sign of TM, and enlarged lymph nodes in the contralateral cervical area may be SMs of primary breast cancer.
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Affiliation(s)
- Wen Wen
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Heng Jiang
- College of Medicine, University of Nebraska Medical Center, Omaha, NE 68133, United States
| | - Hsin-Yu Wen
- Department of Pathology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yu-Lan Peng
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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Celik E, Ozturk T, Samanci N, Demirci N, Akovali B, Demirelli F. Breast cancer to thyroid gland: An unconventional metastatic site. J Cancer Res Ther 2022; 18:788-791. [DOI: 10.4103/jcrt.jcrt_561_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Dong S, Pan J, Shen YB, Zhu LX, Xia Q, Xie XJ, Wu YJ. Factors Associated with Malignancy in Patients with Maximal Thyroid Nodules ≥2 Cm. Cancer Manag Res 2021; 13:4473-4482. [PMID: 34113173 PMCID: PMC8186937 DOI: 10.2147/cmar.s303715] [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: 02/07/2021] [Accepted: 05/15/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose The relationship between large thyroid nodules and the risk of malignancy is controversial. This study aimed to examine the relationship between thyroid nodule size and the risk of malignancy of maximal thyroid nodules ≥2 cm and the risk of accompanied by occult thyroid carcinoma. Methods This was a retrospective study of patients who underwent near-total or total thyroidectomy for thyroid nodules from January 2016 to January 2019 at the First Affiliated Hospital,Zhejiang University School of Medicine. Clinical, biochemical, and pathological characteristics were examined for association with malignancy using univariable, multivariable, and receiver operating characteristic curve analyses. Results Finally, 367 patients (277 females (75.5%) and 90 males (24.5%)) with a mean age of 49.0±13.5 years were included. Multivariable logistic regression analysis showed that age (OR=0.959, 95% CI: 0.939–0.979, P<0.001), Hashimoto’s thyroiditis (OR=2.437, 95% CI: 1.162–5.112, P=0.018), the diameter of maximal nodule (small) (OR=0.706, 95% CI: 0.541–0.919, P=0.010), and punctate echogenic foci (OR=2.837, 95% CI: 1.598–5.286, P<0.001) were independently associated with malignancy. Of 223 patients who had non-suspicious malignant nodules (TI-RADS <4), 12.7% (n=29) patients showed malignancy at postoperative pathology. Only age was associated with occult PTC in the univariable analyses (OR=0.962, 95% CI: 0.934–0.991, P=0.011). When TPOAb was used as a continuous variable for statistical analysis, it showed a significant difference in the ROC curve, and the results showed TPOAb >31.4 mIU/L was more associated with occult PTC (P=0.006). A predictive model including four independent risk factors of malignancy showed an optimal discriminatory accuracy (area under the curve, AUC) of 0.783 (95% CI=0.732–0.833). Conclusion Relatively young age (<54.5 years), Hashimoto’s thyroiditis, the diameter of the maximal nodule, and punctate echogenic foci were independently associated with thyroid malignancy in patients with maximal thyroid nodules ≥2 cm. Young age (<54.5 years) and TPOAb >31.4 mIU/L were associated with occult PTC.
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Affiliation(s)
- Shuai Dong
- Department of Thyroid Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People's Republic of China
| | - Jun Pan
- Department of Thyroid Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People's Republic of China
| | - Yi-Bin Shen
- Department of Thyroid Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People's Republic of China
| | - Li-Xian Zhu
- Department of Thyroid Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People's Republic of China
| | - Qing Xia
- Department of Endocrinology, People's Hospital of Hangzhou Medical College, Hangzhou, 310014, People's Republic of China
| | - Xiao-Jun Xie
- Department of Thyroid Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People's Republic of China
| | - Yi-Jun Wu
- Department of Thyroid Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People's Republic of China
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Wang Y, Zhou S, Yu B, Zhou P, Zhu J, Wei T, Li Z. Case Report and Review of Literature: Thyroid Metastases From Breast Carcinoma. Front Endocrinol (Lausanne) 2021; 12:631894. [PMID: 33776925 PMCID: PMC7994513 DOI: 10.3389/fendo.2021.631894] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 02/15/2021] [Indexed: 02/05/2023] Open
Abstract
RATIONALE The thyroid is a rare site for distant metastases from breast carcinoma. The incidence of thyroid metastases in fine needle aspiration biopsy (FNAB) was less than 0.2%. PATIENT CONCERNS We report a case of 54-year-old woman with a history of breast carcinoma presented with diffuse scattered microcalcifications in thyroid and enlarged bilateral cervical lymph nodes detected on ultrasound (US). Physical examination of the patient revealed firm and enlarged thyroid lobes. DIAGNOSES FNAB and immunohistochemistry (IHC) of the thyroid lesion confirmed the thyroid metastases from breast cancer. INTERVENTIONS AND OUTCOMES Due to the comorbidities of breast carcinoma metastases to the right axillary, cervical lymph nodes and left chest wall, the patient received chemotherapy. After a follow-up of 19 months, the patient was alive without any new distant metastases. LESSONS Our case highlights that thyroid metastases should be considered in a patient combined with thyroid lesions and a history of breast carcinoma. IHC played an important role in differentiating thyroid metastases from primary thyroid cancer.
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Affiliation(s)
- Yichao Wang
- Department of Thyroid & Parathyroid Surgery Center, West China Hospital, Sichuan University, Chengdu, China
| | - Shengliang Zhou
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Boyang Yu
- Department of Sonography, West China Hospital, Sichuan University, Chengdu, China
| | - Ping Zhou
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Jingqiang Zhu
- Department of Thyroid & Parathyroid Surgery Center, West China Hospital, Sichuan University, Chengdu, China
| | - Tao Wei
- Department of Thyroid & Parathyroid Surgery Center, West China Hospital, Sichuan University, Chengdu, China
| | - Zhihui Li
- Department of Thyroid & Parathyroid Surgery Center, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Zhihui Li,
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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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Zhang YY, Xue S, Wang ZM, Jin MS, Chen ZP, Chen G, Zhang Q. Thyroid metastasis from breast cancer presenting with enlarged lateral cervical lymph nodes: A case report. World J Clin Cases 2020; 8:838-847. [PMID: 32149069 PMCID: PMC7052554 DOI: 10.12998/wjcc.v8.i4.838] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 01/01/2020] [Accepted: 01/11/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Secondary malignancy of the thyroid occurs infrequently and mainly originates from malignant tumors of the kidney, gastrointestinal tract, lungs, breast, and skin. The correct diagnosis is important but difficult. Importantly, there are major differences in the treatment of primary and metastatic thyroid cancer, which has a significant impact on prognosis and survival. Therefore, how to diagnose thyroid metastasis (TM) correctly before surgery is a major concern for surgeons.
CASE SUMMARY We report a 38-year-old woman who presented with palpable cervical lymph nodes after breast cancer (BC) surgery 2 years ago. Ultrasonography and computed tomography revealed thyroid nodules with irregular margins and enlarged cervical lymph nodes. Biopsy was performed for the right largest cervical lymph node, and immunohistochemical analysis revealed negativity for thyroglobulin, estrogen receptor, and progestin receptor and positive for human epidermal growth factor receptor 2. The diagnosis was TM from BC with cervical lymph node metastasis. Total thyroidectomy with bilateral central and lateral neck lymph node dissection was performed. After a 5-mo follow-up, no recurrence or novel distant metastasis was identified.
CONCLUSION TM from BC is a rare secondary malignancy. Broad differential diagnosis by biopsy and immunohistochemical analysis needs to be considered.
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Affiliation(s)
- Yan-Yan Zhang
- Department of Thyroid Surgery, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Shuai Xue
- Department of Thyroid Surgery, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Zheng-Min Wang
- Department of Thyroid Surgery, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Mei-Shan Jin
- Department of Pathology, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Zhong-Ping Chen
- Department of Radiology, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Guang Chen
- Department of Thyroid Surgery, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Qiang Zhang
- Department of Thyroid Surgery, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
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Multifocal Metastatic Breast Carcinoma to the Thyroid Gland Histologically Mimicking C Cell Lesions. Case Rep Pathol 2019; 2019:9890716. [PMID: 30956833 PMCID: PMC6431456 DOI: 10.1155/2019/9890716] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 02/21/2019] [Indexed: 12/22/2022] Open
Abstract
The thyroid gland is an uncommon site of metastatic disease. Renal cell carcinoma is the most common primary source, while metastasis from breast carcinoma is very rare. However, given that thyroid nodules are more common in women, and women with a history of breast cancer are at higher risk of developing thyroid cancer, the possibility of metastatic breast carcinoma must be considered when evaluating a thyroid nodule. We present the case of a 67-year-old woman who presented with dysphonia and dysphagia secondary to multinodular goiter and was found to have multifocal metastatic breast carcinoma in her surgical resection specimen. The histologic appearance focally mimicked C cell hyperplasia and medullary thyroid carcinoma, so immunohistochemistry was critical for establishing the diagnosis. Metastasis to the thyroid should always be included in the differential diagnosis for a thyroid nodule in a patient with a history of previous malignancy.
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