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1.
Metastasis to the thyroid gland is very rare. Recently, we experienced a case of thyroid metastasis from breast cancer accompanying a papillary thyroid. A 51-year-old female patient presented with a palpated lymph node on her left lateral neck. The patient had undergone a left modified radical mastectomy followed by chemotherapy and hormonal therapy 12 years prior. Ultrasonography of the neck revealed a malignant looking nodule at the left thyroid lobe, measuring 0.9 × 0.9 cm, and several cystic nodules at the right thyroid lobe. Ultrasonography of the neck additionally revealed a malignant looking lymph node at the right level VI. Fine-needle aspiration of the left thyroid lobe resulted in a diagnosis of papillary thyroid carcinoma and that of the right level VI in Hurthle cell lesion. The patient had a total thyroidectomy with selective dissection of the left neck node. Pathologic assessment of the specimen revealed metastatic carcinoma from the breast carcinoma and papillary thyroid carcinoma. Although the thyroid gland is highly vascularized, metastasis of malignant tumors to the thyroid is relatively rare and detection of metastasis shows a low frequency. So a careful evaluation of thyroid tumor should be considered in a patient with a history of other malignancy.Key words: Metastatic thyroid carcinoma, Breast carcinoma, Papillary thyroid carcinoma 相似文献
2.
目的:探讨滤泡状甲状腺癌骨转移的临床特征和治疗方法。方法:回顾性分析1例以左侧锁骨病理性骨折及骨痛为首发症状的滤泡状甲状腺癌患者的临床影像学资料、病理学资料,随访治疗效果,并复习相关文献。结果:患者左侧甲状腺肿物考虑为滤泡状甲状腺癌。C5、T10椎体、左侧锁骨考虑为转移癌。行左侧锁骨部分切除术,术后病理提示:滤泡状甲状腺癌骨转移。结论:对以病理性骨折和骨痛为主要症状的滤泡状甲状腺癌,影像学与组织活检相结合有利于降低误诊率,治疗方案取决于对患者局部病灶和全身状况的全面评估。 相似文献
3.
Edward J Shillitoe 《Head & neck oncology》2009,1(1):1-5
Background
Papillary carcinoma is the most common differentiated malignant thyroid neoplasm. The biological course of this cancer is typically indolent with a protracted clinical course. Metastases commonly occur in regional lymph nodes, and distant metastasis is a late and rare occurrence. We report a patient who presented with cerebellar metastasis prior to the diagnosis of papillary thyroid carcinoma and review the literature of brain metastasis from papillary thyroid carcinoma.Results
A 75-year old female presented at the emergency room with progressive dizziness, headache and vomiting, where a brain CT and MRI showed a posterior cerebellar tumor. Surgical resection revealed papillary carcinoma consistent with thyroid origin. Subsequent ultrasound and CT-scan revealed a thyroid nodule, after which the patient underwent total thyroidectomy. Pathologic evaluation was consistent with papillary thyroid carcinoma.Conclusion
Brain metastasis may rarely be the initial presentation of papillary thyroid carcinoma. Solitary brain metastasis can completely be resected with better prognosis. 相似文献4.
5.
Esther Diana Rossi MD PhD William C. Faquin MD PhD Liron Pantanowitz MD 《Cancer cytopathology》2019,127(7):432-446
Certain carcinomas of the thyroid gland behave aggressively resulting in increased patient morbidity and poor patient prognosis. The diagnosis of these aggressive thyroid cancer subtypes is sometimes challenging and subject to increased interobserver variability. This review deals with the cytological features of such tumors including aggressive variants of papillary thyroid carcinoma, poorly differentiated thyroid carcinoma, and anaplastic thyroid carcinoma. These malignancies fall into 2 groups based on their cytomorphology: those that exhibit distinct microscopic features (eg, nuclear findings typical of classical papillary thyroid carcinoma or marked anaplasia) and those that present with more subtle cytologic features (eg, nuclear pseudostratification, “soap bubble” nuclei, supranuclear or subnuclear cytoplasmic vacuoles, rosette-like structures, hobnail cells). We review the literature regarding these aggressive thyroid cancers and highlight important phenotypic characteristics that can be useful for their diagnosis based on fine needle aspiration. 相似文献
6.
Metastatic carcinoma of the thyroid is uncommon in surgical pathology and may masquerade as primary thyroid cancer. We studied 6 cases of biopsied and/or surgically resected metastatic carcinoma of the thyroid and their corresponding primary carcinoma, with emphasis on the differential diagnosis. There were 4 men and 2 women patients aged 44 to 77. The primary carcinoma was a breast infiltrating duct carcinoma (3 cases), a colorectal adenocarcinoma (2 cases) and a bronchial oat-cell carcinoma (1 case). The interval between primary carcinoma and secondary thyroid carcinoma was 2 to 9 years in 4 cases; 2 other cases showed simultaneous occurrence. Five patients died with widespread metastases 1 to 14 months following the diagnosis of secondary carcinoma of the thyroid; 1 patient was alive after 24 months. The histological differentiation of secondary from primary thyroid cancer may be difficult in the following situations: clear-cell, Hürthle-cell and signet ring cell changes; positivity of mucins stains; production of melanin; epidermoid differentiation; very rare miscellaneous tumours ("columnar cell carcinoma" and primary thymoma of the thyroid). Immunoperoxidase methods and mucin histochemistry may help. 相似文献
7.
范亚莉 ' target='_blank'> 王娟红 ' target='_blank'> 魏威 张毓 张莹莹 ' target='_blank'> 李娜苗 ' target='_blank'> 董娅 ' target='_blank'> 赵钰玲 ' target='_blank'> 李建英 《现代肿瘤医学》2019,(3):393-396
目的:探讨甲状腺乳头状癌组织中Ku80的表达水平及其与临床病理特征的关系。方法:收集22例甲状腺乳头状癌患者的组织蜡块,应用免疫组化检测甲状腺乳头状癌、癌旁组织中Ku80的表达,并分析Ku80表达与甲状腺乳头状癌临床病理特征的关系。结果:甲状腺乳头状癌组织中Ku80阳性表达率为63.6%,癌旁组织阳性表达率为22.7%,差异有统计学意义(P<0.05);Ku80表达与患者的肿瘤TNM分期中T分期有关(P=0.005),与患者年龄、性别、是否有淋巴结转移、肿瘤大小、发病部位及是否有其他合并症无显著相关性(P>0.05)。结论:Ku80在甲状腺乳头状癌中高表达,并与肿瘤T分期显著相关。 相似文献
8.
Xi Li Ge Zhao Yong ghang Kui Ding Hui Cao Dehua Yang Jian Zhang Zhiquan Duan Shijie Xin 《中国癌症研究》2013,25(5):603-607
Although thyroid carcinoma is a relatively common form of malignancy,metastatic spread to the skull is rare.Here,we report a case of papillary thyroid carcinoma with frontal and parietal metastasis.A 61-year-old Chinese woman presented with a one year history of a growing mass on the center of the frontal and parietal bone,initially thought to be meningioma.Biopsy of the skull base mass after intracalvarium excision,indicated a tumor of thyroid origin.One month later the patient underwent a total thyroidectomy.Pathological examination confirmed a diagnosis of papillary thyroid carcinoma with frontal and parietal bone metastasis.Based on this experience,the key to successful management of the skull metastasis of thyroid carcinoma is prompt diagnosis and appropriate treatment.Skull metastasis should be considered at the outset of the clinical course of papillary thyroid cancer.To facilitate this,patients should be meticulously investigated by a multidisciplinary team to improve quality of life. 相似文献
9.
We present a patient with colon carcinoma metastatic to the thyroid. Review of the literature reveals only a few reports of metastatic colorectal carcinoma to the thyroid. Metastatic tumors of the thyroid are no longer considered rare. Unfortunately, they often remain undetected because only a small minority of patients present with a mass lesion or enlargement of the gland. This is further evidenced by the fact that most reports come from autopsy series. Establishing this diagnosis is important because metastatic deposits in the thyroid can sometimes cause respiratory compromise as well as thyrotoxicosis. 相似文献
10.
Medullary thyroid carcinoma is the least frequent thyroid neoplasm; it originates in thyroid parafollicular cells (calcitonin secreting C cells). In 80% of cases it is sporadic, in the remaining 20% it is familial, associated or not to other endocrinopathies as pheochromocytoma and hyperparathyroidism (MEN 2A, MEN 2B, and isolated familial medullary thyroid carcinoma). Preclinical diagnosis in relatives of affected subjects (preferably at pediatric age) is essential for successful therapy and is performed with genetic and biochemical screening tests. The genetic screening is based on DNA analysis (RET proto-oncogene mutations) of the patient, and if positive of all first degree relatives, to separate sporadic (somatic mutations) from familial (germline mutations) forms. The biochemical screening is based on calcitonin determination and its increase after pentagastrin stimulation, (a peculiar characteristic of medullary thyroid carcinoma, the first biochemical disorder in a subject at risk) and is mainly used in genetically silent familial medullary thyroid carcinoma. The principal negative prognostic factors of medullar thyroid carcinoma and the debate concerning the use of calcitonin determination in the diagnosis of the "cold" thyroid nodule have been analyzed. 相似文献
11.
分化型甲状腺癌术后患者131I治疗效果评估 总被引:1,自引:0,他引:1
目的:对分化型甲状腺癌术后患者131I治疗效果进行评估。方法:对136例术后病理结果为分化型甲状腺癌的患者分别给予口服131I治疗,次数1-3次不等,并于治疗后1周给予甲状腺激素替代治疗,治疗后4-6个月后评估治疗效果。结果:经1次131I治疗后,完全清除残留甲状腺58例(41.91%),2次131I治疗后,完全清除残留甲状腺87例(63.97%),3次131I治疗后,完全清除残留甲状腺达到123例(90.44%),不完全清除12例,无效1例。对甲状腺癌转移灶,经3次131I治疗后,淋巴结转移有效率最高,达90.44%,骨骼转移有效率为55.56%,有效率最低。结论:对DTC术后患者行131I治疗,大部分患者(90.44%)3次即可完全清除残留甲状腺组织;甲状腺癌转移灶经3次131I治疗后,可取得55.56%-90.44%不等有效率。 相似文献
12.
K. Setti S. Touri M. Allaoui Z. Bernoussi N. Mahassini 《Journal africain du cancer / African Journal of Cancer》2014,6(2):111-114
Renal metastases from thyroid carcinoma are extremely rare. In the review of the literature, we found only 25 cases described. We report a 54 years old patient with a history of total thyroidectomy for follicular thyroid carcinoma. The patient presented with a local recurrence 11 years later; he received treatment with iodine. The scan after iodine therapy showed increased uptake focus at the lower pole of the right kidney. Abdominopelvic computed tomography was performed and allowed to highlight a polar lesion. A lower total nephrectomy was performed, and the histological examination was in favor of renal metastasis of thyroid carcinoma. The evolution was marked by the appearance of bone metastases leading to death of the patient 10 months after surgery. The clinical, histological aspects and the therapeutic approach will be discussed after review of the literature. 相似文献
13.
In vitro lysosomal acid protease activity was studied in human papillary thyroid carcinoma (n = 13). As a control, morphologically normal thyroid tissue from the same patient was used in each individual case of carcinoma. Although a marked variation may be observed between individual cases, each examined papillary thyroid carcinoma showed significantly greater activity of acid proteases, both per unit weight of wet thyroid tissue and per unit of lysosomal proteins, in comparison to the corresponding control (range, 24%-248%). In conclusion, it is suggested that enhanced proteolytic activity of lysosomal acid proteases in papillary carcinoma is probably a result of disturbance in catabolic degradation of the thyroglobulin molecule in malignantly transformed thyroid tissue. 相似文献
14.
Emilija Veljkovic Radan Dzodic Gorana Neskovic Boban Stanojevic Zorka Milovanovic Miroslav Opric Bogomir Dimitrijevic 《Medical oncology (Northwood, London, England)》2004,21(4):319-323
Sequence alterations in the RET proto-oncogene are becoming increasingly important to clinical assessment of the malignant
disease of the thyroid. A spectrum of mutations is necessary to establish comprehensive phenotype to genotype relationship
relevant to diagnosis and therapy of thyroid malignancies. We aimed to append to the increasing database of these oncogenic
lesions and, therefore, analyzed DNA from tumor tissue and constitutive DNA from a patient with thyroid carcinoma. Mutational
screening and sequence characterization of the RET proto-oncogene was performed to include part of the intronic sequences.
We report a germline sequence variant in DNA from the patient diagnosed with microfollicular thyroid carcinoma. The carcinoma
presented not as fully developed medullar carcinoma (MTC) but as microfollicular carcinoma with tendency to evolve into MTC.
We characterized the sequence variant located in the intron 10 of the RET oncogene as an A to G substitution denoted IVS10
+ 4G. The described sequence alteration generates a chi-like sequence surrounded by several chi-like sequences with recombinational
potential. Such alteration may be involved in the pathogenesis of the microfollicular carcinoma via genome destabilization
through homologous recombination in the process of tumor progression. This result further substantiates the importance of
the database correlating specific sequence variations in the RET gene with distinct disease phenotypes. 相似文献
15.
Veljkovic E Dzodic R Neskovic G Stanojevic B Milovanovic Z Opric M Dimitrijevic B 《Medical oncology (Northwood, London, England)》2004,21(4):319-324
Sequence alterations in the RET proto-oncogene are becoming increasingly important to clinical assessment of the malignant disease of the thyroid. A spectrum of mutations is necessary to establish comprehensive phenotype to genotype relationship relevant to diagnosis and therapy of thyroid malignancies. We aimed to append to the increasing database of these oncogenic lesions and, therefore, analyzed DNA from tumor tissue and constitutive DNA from a patient with thyroid carcinoma. Mutational screening and sequence characterization of the RET proto-oncogene was performed to include part of the intronic sequences. We report a germline sequence variant in DNA from the patient diagnosed with microfollicular thyroid carcinoma. The carcinoma presented not as fully developed medullar carcinoma (MTC) but as microfollicular carcinoma with tendency to evolve into MTC. We characterized the sequence variant located in the intron 10 of the RET oncogene as an A to G substitution denoted IVS10 + 4G. The described sequence alteration generates a chi-like sequence surrounded by several chi-like sequences with recombinational potential. Such alteration may be involved in the pathogenesis of the microfollicular carcinoma via genome destabilization through homologous recombination in the process of tumor progression. This result further substantiates the importance of the database correlating specific sequence variations in the RET gene with distinct disease phenotypes. 相似文献
16.
Sathiya Murali Jawahar Nagasundaram S. Raghunandhan Kiran Natarajan Mohan Kameswaran A. Chowdary 《Indian journal of otolaryngology and head and neck surgery》2009,61(1):82-85
Carcinomatous transformation of ectopic thyroid elements within the thyroglossal tract is a rare entity. We report a case of primary papillary carcinoma of thyroid presenting within the thyroglossal duct cyst in a 23 year old gentleman. The patient presented to us, as a case of suprahyoid thyroglossal cyst with sub-lingual involvement and he underwent surgical excision of the entire thyroglossal tract by Sistrunk’s approach. The post-operative histopathological diagnosis was of a papillary carcinoma within the thyroglossal duct cyst. Hence, the patient was evaluated for a malignant focus in the thyroid which proved negative. He was counseled regarding the possibility of developing Carcinoma in the thyroid gland and offered two options of further management viz., total thyroidectomy followed by life long thyroid suppression or watchful observation and follow up. As the patient belonged to the low risk group, he opted for the second option. He is presently kept under meticulous follow up and remains asymptomatic till date. We present the pre- and post-operative imaging, intra-operative findings, histo-pathological features and review the present world literature on this rare entity. 相似文献
17.
D Flanagan P Gibb A Skene J McCutcheon M Armitage 《European journal of surgical oncology》2000,26(2):177-180
Papillary cell carcinoma of the thyroid is a relatively indolent disease, usually presenting as an asymptomatic mass in the thyroid gland that is either noted by the patient or diagnosed at routine clinical examination. Although the prognosis is generally good there are a number of controversies in the management of this condition. The significance of age at presentation, size of the tumour and the presence of lymph node metastasis are still disputed. We present the unusual case of a woman found to have papillary cell thyroid carcinoma within a lymph node during a cosmetic thyroid lobectomy. The thyroid tissue removed was not found to contain tumour. We describe the evidence behind the decision to proceed to total thyroidectomy and the finding of a tiny focus of papillary cell thyroid carcinoma within the contralateral lobe. 相似文献
18.
The patient was a 66-year-old man who complained of goiter. A diagnosis of functioning thyroid tumor was made because of high uptake of 131I after T3 suppression test and no response to thyrotropin releasing hormone. The tumor was removed and histologically proven to be follicular carcinoma. Twelve cases of thyroid carcinoma in autonomously functioning thyroid nodules have been reported, and the relation between carcinoma and an autonomously functioning nodule is reviewed from the literature. 相似文献
19.
彩超诊断甲状腺癌颈部淋巴结转移的临床价值 总被引:1,自引:1,他引:1
为了术前超声扫描检查甲状腺癌患者的颈部,有无颈部淋巴结转移,为临床拟定手术方式提供有价值的信息。收集中国协和医科大学肿瘤医院198例甲状腺癌伴颈部淋巴结肿大的患者,详细扫描颈部各区域,按颈部分区精确记录淋巴结的部位及超声影像特点。结果经手术病理确诊198例患者中有177倒为淋巴结转移,3例为颈部淋巴结核,1例为恶性淋巴瘤,17例为淋巴结炎性病变。177例颈部淋巴结转移的患者中,140例诊断正确,准确率为79%。其他21例患者有8例诊断正确,准确率为38%。初步研究结果提示,超声诊断甲状腺癌颈部淋巴结转移的准确率较高,对临床拟定手术方式具有重要的指导意义,可作为术前常规的检查项目。 相似文献
20.
Kruljac I Pavic I Matesa N Mirosevic G Maric A Becejac B Ivkic M Zadravec D Katinic K Vrkljan M 《Japanese journal of clinical oncology》2011,41(9):1142-1146
Intrathyroidal parathyroid carcinoma is extremely rare clinical entity with potentially multiple diagnostic pitfalls. We report a case of 40-year-old man presented with classical manifestations of primary hyperparathyroidism, severe hypercalcemia and profoundly increased serum parathyroid hormone level. Neck ultrasonography demonstrated multinodular goiter with predominant 34 mm nodule in left thyroid lobe. Additional 16 mm nodule was found beneath the left lobe. Routine percutaneous fine-needle aspiration of predominant nodule indicated follicular thyroid carcinoma, while left inferior nodule was confirmed to be of parathyroid origin. The patient underwent surgery, during which frozen sections identified medullary thyroid carcinoma with metastasis to upper mediastinal lymph node. Permanent sections of the predominant left lobe nodule revealed intrathyroidal parathyroid carcinoma surrounded with multiple microscopic metastases. Left inferior nodule was metastatic lymph node. Additional 10 mm intrathyroidal metastasis of primary parathyroid carcinoma was found within right thyroid lobe. This case indicates that fine-needle-aspiration and intraoperative biopsy are of limited value in diagnosing parathyroid carcinoma, especially if localized intrathyroidally. Oncological en-block resection is treatment of choice, implying ipsilateral lobectomy in case of thyroid invasion. This firstly described case of intrathyroidal parathyroid carcinoma causing intrathyroidal dissemination may influence future treatment strategies. 相似文献