Metastasis to the thyroid gland: Characterization and survival of an institutional series spanning 28 years |
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| Institution: | 1. Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden;2. Department of Internal Medicine, Eskilstuna Hospital, Eskilstuna, Sweden;3. Department of Pathology and Cytology, Karolinska University Hospital, Stockholm, Sweden;4. Department of Oncology-Pathology, Karolinska Institutet, BioClinicum, Stockholm, Sweden;5. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden;6. Department of Breast, Endocrine Tumours and Sarcoma, Karolinska University Hospital, Stockholm, Sweden;1. Institute of Cancer Medicine, University of Liverpool, UK;2. The Countess of Chester Hospital NHS Foundation Trust, Chester, UK;1. Center for Gastrointestinal Malignancies, MedStar Washington Hospital Center, Washington, DC, USA;2. Biostatistics and Biomedical Informatics Department, Medstar Health Research Institute, Hyattsville, MD, USA;1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea;2. Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, South Korea;3. Department of Pathology, Seoul National University College of Medicine. Seoul, South Korea;4. Department of Pathology, Seoul National University Boramae Medical Center, Seoul, South Korea;5. Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea;6. Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, South Korea;7. Division of Public Healthcare Policy, National Medical Center, Seoul, South Korea;8. Department of Pathology, Seoul National University Hospital, Seoul, South Korea;9. Department of Surgery, Seoul National University Boramae Medical Center, Seoul, South Korea;10. Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, South Korea;1. ENETS Neuroendocrine Tumor Centre of Excellence, Rigshospitalet, Copenhagen University Hospital, Denmark;2. Dept. of Endocrinology, Rigshospitalet, Copenhagen University Hospital, Denmark;3. Dept. of Pathology, Rigshospitalet, Copenhagen University Hospital, Denmark;4. Dept. of Surgery, Rigshospitalet, Copenhagen University Hospital, Denmark;5. Dept. of Oncology, Rigshospitalet, Copenhagen University Hospital, Denmark;6. Dept. of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Copenhagen University Hospital, Denmark;1. Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital 20 College Road, Singapore;2. Hepatopancreatobiliary Unit, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Calle de Diego de León, 62, 28006 Madrid, Spain;3. Hepatopancreatobiliary Unit, Parc Salut Mar Hospital, Barcelona, Passeig Marítim de La Barceloneta 25, 08003, Spain;4. Department of Surgery, Poliambulanza Foundation Hospital, Brescia, Via Leonida Bissolati, 57, 25124, Italy;5. Yong Loo Lin School of Medicine, National University Singapore, Singapore 10 Medical Drive, 117597, Singapore;6. Duke NUS Medical School, Singapore (8 College Rd, 169857, Singapore;7. Hepatobiliary Surgery and Liver Transplant Unit, Cruces University Hospital, Cruces Plaza, S/N, 48903 Barakaldo, Bizkaia, Spain;8. BioCruces Research Institute, University of the Basque Country Cruces Plaza, 48903 Barakaldo, Bizkaia, Spain;1. Institute of Neuroscience, Geisinger Commonwealth School of Medicine, Danville, PA, USA;2. Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA;3. Department of Neurosurgery, Tel-Aviv Medical Center, Tel-Aviv, Israel, Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel;4. Department of Otolaryngology–Head and Neck Surgery, Tel-Aviv Medical Center, Tel-Aviv, Israel, Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel |
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| Abstract: | IntroductionSecondary neoplasms in the thyroid are rare. The study aim was to provide an overview of non-thyroid tumours that metastasize to the thyroid through our institutional experience.Materials and methodsThis study entailed a review of the pathology database searching for patients with metastasis to the thyroid at the Karolinska University Hospital between 1992 and 2019 and review of their medical files.ResultsOut of 1939 surgical procedures with a histopathological diagnosis of a thyroid malignancy, 31 cases (1.6%, 65% females) with a diagnosis of metastatic epithelial neoplasms to the thyroid gland were identified. The median age at discovery of the thyroid metastasis was 68 years (range 48–85). The most common primary tumours were clear cell renal cell carcinoma (ccRCC) (36%), followed by non-small cell lung cancer (19%), oesophageal cancer (16%), head and neck malignancies (16%), malignant melanoma (10%) and unknown primary tumour (3%). The median time from the diagnosis of the primary tumour to diagnosis of the thyroid metastasis was 20 months (0–232) and was longest for patients with ccRCC (median 107 months). At 12 months after the non-thyroid metastasis diagnosis 48% had died. The longest survival was observed in ccRCC and the shortest in lung cancer. Surgical management of the metastasis was associated with improved survival (25 vs 3.8 months, p = 0.001).ConclusionsNon-thyroid metastases to the thyroid were rare but should be suspected in patients with previous history of non-thyroid malignancy and a thyroid nodule. Prognosis was poor, but surgical management was beneficial in selected patients. |
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| Keywords: | Thyroid gland Metastases Thyroidectomy Mortality Survival Clear cell renal cell carcinoma |
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