A case of metastasis of rectal cancer to the thyroid gland

A 34-year-old male who showed a rectal mass upon irrigoradioscopy was admitted on October 6, 1979. Abdominoperineal amputation of the rectum was performed on October 11. Histopathological examination revealed that the tumor was adenocarcinoma of the well differentiated type, s, n0., stage II. The patient received chemotherapy and immunotherapy for 10 months postoperatively. In September 1981, enlargement of the thyroid gland associated with pain was noted and on January 12, 1982 total thyroidectomy was performed. Histologically, a diagnosis of well-differentiated adenocarcinoma, which was a metastasis from the rectal cancer, was made. On August 15, 1982, the patient died of generalized metastases.     

Second primary breast cancer following thyroid cancer: report of two cases

Two cases of second primary breast cancer following thyroidcancer are presented. The association between breast and thyroidcancer is reviewed from the literature, but no common etiologicfactor is found between the two neoplasms in our experience.     

原发性甲状腺鳞状细胞癌2例病例报道并文献复习

原发性甲状腺鳞状细胞癌是一种临床罕见的甲状腺恶性肿瘤,其恶性程度高,侵袭力强,临床上早期诊断困难,根治手术难度较大,预后极差,中位生存期约6个月。治疗上以手术为主。对于不能行手术治疗的患者,可行放射治疗,放射治疗在一定程度上可提高局控率,化疗方面没有显示明显的优势。     

Benign tumors of heterotopic tissue in the thyroid gland: a report of two cases of lipomatous lesions

A report of two cases, concerning heterotopic nests of fat cells in the thyroid gland, is presented here together with a review of lipomatous lesions in the literature. Both cases involved patients who presented with goiter; one had Grave's disease and the other had adenomatous hyperplasia. The fat cells were principally located in the subcapsular areas and scattered among the follicles. The distribution of the immunohistochemical staining, and the morphologic characteristics of the adipose tissue, suggested a probable origin of the fat cells from inclusion nests during embryogenesis of the thyroid gland.     

A Case Report of Thyroid Gland Squamous Carcinoma with Multiple Metastases

The patient was a female, 65 years to feel intermittent discomfort in old. Early in 1996, she began her neck, accompanied with hoarseness. In June, 2000, when she entered our hospital and accepted a physical examination, we found a 3 cm×2 cm tumor at the lower pole of the thyroid gland. Neck CT showed that the mass was located at the inferiorposterior right part of the thyroid gland with a diffuse boundary. MRI showed that the right thyroid cartilage wall was incomplete. Fine-needle aspiration cytology indicated a suspected papillary tumor.     

Clinicopathological report: bilateral choroidal metastases from papillary thyroid cancer

Bilateral uveal metastases from papillary thyroid carcinoma are extremely rare. A 36-year-old woman with a 12-month history of papillary thyroid carcinoma presented with sudden loss of visual acuity and fields in the left eye. An examination and B-scan revealed a large, solid choroidal lesion in the left eye causing exudative retinal detachment. A small solid mass was also observed in the right eye fundus. Following left eye enucleation, immunohistopathology confirmed metastatic papillary thyroid carcinoma. The authors report the third known case of bilateral choroidal metastases.     

Metastatic tumours to the thyroid gland: report of 3 cases and brief review of the literature

Background

Metastases to the thyroid are encountered rarely in clinical practice, but the number of cases seems to have increased in recent years. The reason of this increase may be a more frequent use of fine-needle aspiration biopsy (FNAB) and the use of more sophisticated, complicated imaging techniques in patients with thyroid masses. Also, in addition to these reasons, the use of more organo-specific immunohistochemical antibodies in the examination of surgical specimens may affect the differential diagnosis of malignant tumours.

Case reports

Three metastatic tumours to thyroid were found in the retrospective review of malignant thyroid tumours diagnosed between January 1993 and December 2007. The primary tumours were clear cell carcinoma of the kidney, squamous cell carcinoma of the lung and breast carcinoma-ductal type.

Conclusions

A detailed clinical history, careful histological examination and essential immunohistochemistry helped in attaining the correct diagnosis.     

Isolated breast metastases from gastrointestinal carcinomas: report of two cases

Two patients with metastatic gastrointestinal adenocarcinoma in the breast are reported. Metastases in the breast are usually painless upper outer quadrant masses. On mammography they are typically well-circumscribed lesions without microcalcifications. A breast mass in a patient with a history of cancer, even if clinically or mammographically benign, should raise suspicion of a metastasis. Pathological features include a histologic pattern similar to the primary neoplasm and an absence of in situ carcinoma which characterizes primary breast cancer. Surgical excision for local control and systematic therapy is the most appropriate treatment.     

Leptomeningeal metastases originated from esophagogastric junction/gastric cancer: A brief report of two cases

Leptomeningeal carcinomatosis is a very rare manifestation in patients diagnosed with esophagogastric junction and gastric cancer. Its prognosis is ominous and therapy outcomes are disappointing. Herein, we present two patients; one initially diagnosed with gastric cancer and leptomeningeal carcinomatosis but no other evidence of metastatic disease and the other one initially diagnosed with esophagogastric junction cancer, who recurred solitary with leptomeningeal seedings several years after the initial diagnosis and treatment. Furthermore, a thorough and short review of the literature is carried out.     

甲状腺及臀部孤立性纤维性肿瘤2例报道及临床病理学分析

目的:探讨孤立性纤维性肿瘤(solitary fibrous tumor,SFT)的临床、病理组织学、免疫组织化学等特点。方法:报道2例原发于罕见部位的SFT。例1发生在男性右甲状腺,例2发生在女性左臀部。观察2例罕见部位SFT病理组织学特点及免疫组织化学结果。结果:甲状腺及臀部的肿块最大径分别为4.5cm和7cm,两例均为单个孤立的椭圆形结节,有纤维性假包膜。镜下甲状腺SFT与其它文献报道相符合,呈良性形态,臀部SFT局灶肿瘤细胞密集具有非典型性并有出血、坏死,核分裂<4/10HPF。免疫组化染色两例均示肿瘤细胞表达CD34、Vimentin、Bcl-2及CD99阳性。例1甲状腺标记物TG,TTF-1肿瘤细胞表达阴性。结论:发生在甲状腺和臀部的SFT均属罕见。与其他部位发生的肿瘤具有相同的病理组织学特点和免疫组化表达,肿瘤细胞呈梭形和卵圆形,有血管外皮瘤样组织学特点,伴有硬化区和多量胶原纤维。因SFT组织学形态多样性,易与其他软组织肿瘤混淆,正确诊断有赖于病理组织学形态及免疫组化特点。甲状腺SFT多为良性,臀部SFT易发恶性,因SFT生物学行为的不定性,需要长期随访。     

Bilateral pulmonary resection for lung metastases: report of two cases.

Resection of bilateral pulmonary metastases is exceptional. However, in carefully selected patients extensive resections might be successfully performed. We report two patients who underwent a pneumonectomy and excision of pulmonary metastases in the other lung, via a left wedge resection for patient 1 and left segmentectomy for patient 2. Resections were carried out for metastases of a malignant fibrous histyocytoma and for a teratocarcinoma. Both patients are still alive 9 months and 4 years after their last metastasectomy, respectively.     

Prostate cancer metastasis to thyroid gland

Metastases to the thyroid gland are rarely encountered in clinical practice. They may originate from various primary sites, mainly kidney, lung, breast, esophagus and uterus. Prostate cancer is one of the most frequent malignancies in men. It generally has a favorable course, and autopsy series have shown occult prostate cancer in many subjects, especially in aged males. However, prostate cancer sometimes exhibits an aggressive behavior and cases with a poor prognosis have been reported. Occasional reports of metastasis from prostate cancer to the thyroid gland have been documented. We describe the case of a 73-year-old patient presenting with thyroid metastasis from long-standing prostate cancer.     

Squamous cell carcinoma of the thyroid: a report of two cases.

Two patients with squamous cell carcinoma, which accounts for 1.1% of all primary thyroid carcinomas, are described. Squamous metaplasia is the most likely etiology, but an occasional carcinoma may be derived from remnants of embryonic origin. Although squamous metaplasia has been documented in several conditions involving the thyroid, no evidence exists that this predisposes to squamous cell carcinoma. Metastases and direct extension of squamous cell carcinoma in the thyroid gland are much more frequent than primary involvement and are always part of a generalized carcinomatosis. A primary lesion must always be sought; however, diagnosis may not be possible until an initially occult tumor becomes evident or even until autopsy. Because this lesion typically runs a fulminant course, radical surgical resection at the earliest opportunity offers the best hope for cure. The lesions are usually radioresistant, and chemotherapy has not been shown to alter the course of this disease.     

77例直肠癌伴肝转移患者的预后因素分析

目的 探讨影响直肠癌伴肝转移患者预后的相关因素.方法 回顾性分析77例直肠癌伴肝转移患者的临床病理资料,以Kaplan-Meier法分析患者的总生存率,以Log rank检验和Cox模型对影响患者生存的临床病理因素进行单因素和多因素分析.结果 全组患者的中位生存时间为12个月,1、2、3和5年生存率分别为47.7%、28.0%、13.1%和1.5%.单因素分析结果显示,原发肿瘤的分化程度越低、肠壁浸润程度越深、有淋巴结转移、肝转移灶分布于双叶、肝转移灶数目＞1个、肝转移灶的最大直径＞5 cm、有肝外受侵或转移、确诊时癌胚抗原(CEA)≥5 ng/ml以及未行根治性手术者的预后较差(均P＜0.05).多因素分析结果显示,原发肿瘤的分化程度(P=0.007)、肠壁浸润深度(P=0.027)、肝转移灶的最大直径(P=0.003)以及确诊时的CEA水平(P=0.000)为影响直肠癌伴肝转移患者预后的独立因素.结论 对于直肠癌伴肝转移的患者,原发肿瘤的分化程度越高、肠壁浸润越浅、肝转移灶的最大直径越小以及确诊时CEA水平越低,患者的预后越好.     

直肠癌全直肠系膜切除术临床应用(附27例报告)

目的研究直肠癌患者行全直肠系膜切除术(TME)的临床疗效。方法对27例行TME术式的直肠癌患者的临床资料进行分析。结果27例均获根治性切除，15例行吻合器吻合，术后发生吻合口瘘2例。术后辅助化疗及放疗，近期无局部复发病例。结论TME是降低直肠癌术后局部复发率，提高生活质量的有效措施。直肠癌根治性手术中采用TME手术方法是非常重要的。     

Rare histologic types of rectal cancer: A monocentric cases series report

Purpose

There is paucity of data on rectal cancer with uncommon histologic types. The objective was to describe managements of care and outcomes in patients with rectal cancer of histologic types other than adenocarcinoma.

Percutaneous ethanol injection therapy for patients with inoperable thyroid papillary cancer: a report of two cases

Percutaneous ethanol injection therapy (PEIT) has been proposed for the treatment of autonomously functioning thyroid nodules and cysts. We report two patients with inoperable thyroid papillary cancer treated with PEIT, which has not, to date, been used frequently for this purpose. One patient, who had a large thyroid papillary cancer, had had liver cirrhosis for more than 5 years. The other patient was elderly and had diabetes mellitus and chronic hepatitis. In both patients, there was massive adhesion between the tumor and the trachea. Because a complete resection would have been both difficult and risky for either patient, we elected to use the PEIT procedure. The tumors regressed markedly in size as a result of the repetition of PEIT. There were no severe complications in either patient, except for slight pain and transient mild dysphagia. PEIT may be a useful treatment for patients with advanced thyroid papillary cancer and/or for those patients at high risk for surgical remedies; it is a viable option for patients with inoperable disease. Received: February 12, 1999 / Accepted: May 15, 2000     

46例直肠癌远端系膜内扩散情况

背景与目的:全直肠系膜切除可能因为清除了直肠癌远端系膜内的转移灶而获得较低的局部复发率,但直肠癌的远端系膜扩散情况如何、应该切除多长系膜才足够等问题尚无定论.本研究的目的是探讨直肠癌远端系膜内扩散的情况,为根治术提供更充分的临床病理证据.方法:应大切片连续切片、HE染色方法观察46例直肠癌根治术后标本中肿瘤远端扩散的方式和距离,并用Logistic回归方法分析其与临床病理因素的关系.结果:远端肠壁内浸润的发生率为10.9%(5/46),最远距离1.5cm;远端系膜内扩散发生率为21.7%(10/46),最远距离为4cm;扩散的方式有淋巴结转移、孤立的癌结节、脉管和神经浸润.多因素分析显示TNM分期是远端扩散的唯-影响因素.结论:直肠癌远端系膜内扩散较常见,根治术时应切除不少于5 cm的远端直肠系膜.     

Isolated metastasis of lung cancer to the thyroid gland

A 67-year-old man with lung cancer developed an isolated metastasis to the thyroid gland. The patient had undergone a right upper lobectomy, followed by chemotherapy consisting of cisplatin and etoposide based on post-surgical diagnosis of small cell lung cancer. Four years later, he had an isolated metastasis to the thyroid gland. The patient underwent a metastasectomy and adjuvant chemotherapy including cisplatin and irinotecan. The cancer cells in resected thyroid tumor had large nuclei and cytoplasm, and expressed the neuroendocrine markers, CD56 and chromogranin A. Retrospectively, the primary lung cancer consisted of both small cell and large cell cancer, and the latter was consistent with the pathological finding of the thyroid tumor. This is the first report to document an isolated recurrence of the lung cancer to the thyroid.