Rare Metastases in Thyroid Cancer
Journal: Advances in Medicine and Engineering Interdisciplinary Research DOI: 10.32629/ameir.v3i2.3777
Abstract
Introduction: Papillary thyroid carcinoma is the most common endocrine malignancy worldwide, with a rate of regional metastasis in more than 50% of patients and distant metastasis up to 10%, the most frequent being lung and bone, with the appearance of extremely rare skin lesions, in which the overall survival prognosis decreases at 5 years when these lesions are present, even more so in patients over 45 years of age. Clinical case: We present a 64-year-old female patient with classic papillary thyroid carcinoma of 1-year evolution, with atypical findings such as intratumoral hemorrhage observed when performing fine-needle aspiration puncture, requiring drainage until the time of surgery due to persistence of bleeding. Additionally, the patient also developed a metastatic lesion in the neck region, located 2 cm below the primary tumor and the puncture area, which was histologically confirmed. The treatment used was tumor and metastatic surgical resection, along with right cervical and level VI dissection, followed by postoperative radioactive iodine ablative therapy, achieving satisfactory results. Discussion: After the development of cutaneous metastasis from thyroid carcinoma, patient survival ranges from 1 month to 7 years, with a mean of 19 months. The exact mechanism of this metastatic spread remains unclear, although current hypotheses suggest that both lymphatic and hematogenous dissemination may contribute to this pattern of neoplastic proliferation.
Keywords
papillary carcinoma; metastasis; skin; hemorrhage
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[3] Sciscent BY, Eberly HW, Goyal N, Goldenberg D. Thyroid cancer with cutaneous metastases. Ear, Nose & Throat Journal. [Internet]. 2024; 0(0). Doi:10.1177/01455613241239533. Disponible en: http://dx.doi.org/10.1177/01455613241239533
[4] García C, Mata JF, Pinto Y, y colaboradores. II Consenso de carcinoma diferenciado de tiroides. Sociedad Venezolana de Oncología [Internet]. 12 de noviembre de 2019; 32(1):41-76. Disponible en: https://site.oncologia.org.ve/upload/revista/pdf/07._garcia_j_(41-76).pdf
[5] Fernández M. Patología y cirugía de las glándulas tiroides y paratiroides. [Internet]. 2015; Sociedad española de otorrinolaringología y patología cérvico-facial. Pág.129-142. Disponible en: https: //seorl.net/PDF/ponencias%20oficiales/2015%20Patolog%C3%ADa%20y%20cirug%C3%ADa%20de%20las%20glandulas%20tiroides%20y%20paratiroides.pdf
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[7] Haugen B-R, Alexander E-K, Bible K-C y colaboradores. American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American thyroid association guidelines task force on thyroid nodules and differentiated thyroid Cancer. [Internet]. 2016; 26: 1-133. Disponible en: https://doi.org/10.1089/thy.2015.0020
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[9] Dahl PR, Broadland DG, Goellner JR, Hay ID. Thyroid carcinoma metastatic to the skin: a cutaneous manifestation of a widely disseminated malignancy. J Am Acad Dermatol. [Internet]. 1997;36(4):531-7. Disponible en: https://doi.org/10.1016/S0190-9622(97)70239-1
[10] Madani A, Jozaghi Y, Tabah R, How J, Mitmaker E. Rare metastases of well-differentiated thyroid cancers: a systematic review. Ann Surg Oncol. [Internet]. 2015; 22(2):460-6. Disponible en: https://link.springer.com/article/10.1245/s10434-014-4058-y
[11] Yoon JH, Jeon MJ, Kim M, Hong AR, Kim HK, Shin DY, Kim BH, Kim WB, Shong YK, Kang HC. Unusual metastases from differentiated thyroid cancers: a multicenter study in Korea. PLoS One. [Internet]. Agosto del 2020; 25;15(8): e0238207. Doi: 10.1371/journal.pone.0238207. Disponible en: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0238207
[12] Liu Z, Liu X, Xu Q, Lin C. Papillary thyroid carcinoma with shoulder skin metastasis: a case report and literature review. Asian J Surg. [Internet]. Octubre del 2022; 45(10):1966-1967. Doi: 10.1016/j.asjsur.2022.04.037. Disponible en: https://pubmed.ncbi.nlm.nih.gov/35490072/
[13] Jiang W, Quan R, Bhandari A, Hirachan S, Chen C, Lv S, Zheng C. PAFAH1B3 regulates papillary thyroid carcinoma cell proliferation and metastasis by affecting the EMT. Curr. Med. Chem. [Internet]. 2024;31(9):1152-1164. Doi: 10.2174/0929867330666230427102920. Disponible en: https://pubmed.ncbi.nlm.nih.gov/37102492/
[14] Kwon H, Kim H, Park S, Song DE, Kim WG, Kim TY, Shong YK, Kim WB. Solitary skin metastasis of papillary thyroid carcinoma. Endocrinol Metab (Seoul). [Internet]. 2014; 29(4):579-83. Doi: 10.3803/EnM.2014.29.4.579. Disponible en: https://pubmed.ncbi.nlm.nih.gov/25325268/
[15] Bhargava A, Mahakalkar C, Kshirsagar S, Bothara S, Bhawani J. A case report of a metastatic papillary carcinoma of the thyroid. Cureus. [Internet]. 2024; 16(3): e55627. Doi: 10.7759/cureus.55627. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10995986/
[16] Limaiem F, Rehman A, Anastasopoulou C, Mazzoni T. Papillary Thyroid Carcinoma. StatPearls. 2023. [Internet]. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK536943/
[17] Yang H, Zhao S, Zhang Z, Chen Y, Wang K, Shang M, Chen B. The associated factors for spontaneous intranodular hemorrhage of partially cystic thyroid nodules: A retrospective study of 101 thyroid nodules. Medicine (Baltimore). [Internet]. 2020;99(51):e23846. Doi: 10.1097/MD.0000000000023846. Disponible en: https://pubmed.ncbi.nlm.nih.gov/33371167/
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