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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Direct invasion of the trachea by an aggressive tumor originating in the thyroid gland is an unusual but well-documented phenomenon. The reverse situation, that is, a primary tracheal neoplasm invading by direct extension into the thyroid gland and presenting as a thyroid mass is apparently an even less common occurrence. A careful search of the literature has failed to reveal any recorded instances of this type of occurrence. We report a case of an adenoid cystic carcinoma arising in the trachea and invading the thyroid gland and recurrent laryngeal nerves causing vocal cord paralysis. The presentation of this lesion as a primary thyroid tumor is an unusual occurrence that serves to remind the clinician that in the differential diagnosis of thyroid masses one must include the possibilities of metastases or direct extension of a primary neoplasm from another organ.
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PMID:Tracheal carcinoma presenting as a thyroid tumor. 608 94

The columnar cell variant of thyroid papillary carcinoma is an aggressive tumor associated with widespread dissemination and a fatal outcome. We report a case of a 29-year-old white woman who presented with a large thyroid mass extending into the mediastinum with local and distant metastases. The histologic features included focal papillary growth with columnar cells and nuclear stratification. However, the histologic picture was dominated by cells with a clear to vacuolated-appearing cytoplasm similar to that seen in association with secretory-type endometrium. In addition, areas of solid growth and organoid or glandular features were also identified. This tumor followed an aggressive course with widespread metastatic disease unresponsive to all therapeutic intervention. The patient died 7 months after diagnosis. We believe this tumor represents the columnar cell variant of thyroid papillary carcinoma. This is only the second reported case of columnar cell carcinoma to occur in a female. Other than the unusual occurrence in a woman, the clinical and pathologic features of this case are similar to those previously reported, including an aggressive behavior followed rapidly by the death of the patient.
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PMID:The columnar cell variant of thyroid papillary carcinoma. Case report and discussion of an unusually aggressive thyroid papillary carcinoma. 761 41

Thyroid gland scintigraphy was performed in 29 dogs with histologically confirmed thyroid tumors. Twenty dogs were female, and 9 were male. Median age was 10 years. Of the 29 dogs, 21 were initially examined because of cervical swelling or a cervical mass. Of the 29 tumors, 24 were thyroid adenocarcinomas, 1 was a C-cell carcinoma, 3 were undifferentiated carcinomas, and 1 was a thyroid adenoma. Serum triiodothyronine and thyroxine concentrations were determined in 25 dogs. Sixteen dogs were euthyroid, 6 were hyperthyroid, and 3 were hypothyroid. In all 29 dogs, results of scintigraphy were abnormal. The most common scintigraphic appearance (13 dogs) was a unilateral thyroid mass with increased radionuclide uptake, relative to that of the parotid salivary glands. There did not appear to be an association between distribution of radionuclide uptake and histologic diagnosis, although there appeared to be an association between distribution of uptake and histologic degree of capsular invasion. All 4 dogs with extensive capsular invasion and 11 of 17 dogs with limited capsular invasion had poorly circumscribed, heterogeneous uptake of pertechnetate by the tumor. All hyperthyroid dogs had intense uptake, and 5 of 6 hyperthyroid dogs had well-circumscribed, homogenous uptake. Scintigraphy did not appear to offer any additional benefit, compared with thoracic radiography, for detection of pulmonary metastases.
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PMID:99mTc-pertechnetate imaging of thyroid tumors in dogs: 29 cases (1980-1992). 817 71

The present study characterizes papillary thyroid carcinoma (PTC) in a Mexican patient sample and evaluates potential prognostic factors for recurrence. Clinical records of 229 patients with PTC were analyzed. Surgical specimens were rereviewed and DNA ploidy determined. Cox logistic regression was used to explore prognostic factors. Mean age +/- SD of the patients was 42 +/- 16 years, with a male/female ratio of 24:205. A thyroid mass was the initial manifestation in 99%. Extrathyroid invasion occurred in 45% and nodal metastases in 38%. Mean size +/- SD of the tumors was 3 +/- 2 cm. By flow cytometry 88% of the tumors were DNA euploid and 12% aneuploid. Complete tumor resection was achieved in 83% with an operative mortality of 0.4%. Postoperative hormone suppression was administered in 65% and remnant 131I thyroid ablation in 84%. The 10-year recurrence-free survival was 85%. In the group of patients with tumors totally removed and without distant metastases, none of the 14 evaluated variables demonstrated statistical significance as an independent prognostic factor for recurrence. However, the group of patients in whom a combination of the following factors was present--age > or = 40 years, tumor size > or = 3 cm, local invasion, and lymph node metastases--showed a higher incidence of tumor recurrence.
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PMID:Papillary thyroid carcinoma in Mexican patients: clinical aspects and prognostic factors. 858 21

Total 19 cases of medullary thyroid carcinoma (MTC) diagnosed at Chang Gung Memorial Hospital from Jan. 1979 to Dec. 1994 were studied retrospectively. All of them were pathologically proved. All cases except one were thought as sporadic MTC. The gender distribution showed a female preference with female : male (F:M) ratio of 3.8:1. The mean age at diagnosis was 44.9 +/- 13.7 years. The most common clinical presentation was thyroid mass in all (100%). The staging of MTC in our cases demonstrated: 12 (63%) stage I, 1 (5%) stage II, 3 (16%) stage III, and 3 (16%) stage IV. Thyroid ultrasonography with fine-needle aspiration cytology (FNAC) were performed in 15 patients. Eleven cases were diagnosed as malignancy, including 5 cases diagnosed as MTC preoperatively. Neck nodal metastases were noted in 7 cases and all occurred in tumors larger than 3 cm. All cases received operation according to clinical stage. Six of 7 patients who had preoperative calcitonin data showed abnormal high values. After operation, there were 8 patients with persistent hypercalcitoninemia. Of these, 5 received 131I therapy which induced undetectable calcitonin level in 2 stage I patients. Three cases received external beam radiotherapy but all failed. During a period of 0.5 to 9.4 years follow-up (mean +/- SE: 3.6 +/- 0.7 years), 3 patients died of pulmonary infection, 1 lost follow-up and 15 patients are alive and well. In conclusion, the preliminary data suggests that the medullary thyroid carcinoma in Taiwan has following characteristics: (1) gender distribution showed a female preference; (2) accuracy of preoperative FNAC was 42%; (3) most of the diagnoses of MTC were made postoperatively.
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PMID:Clinical experience of medullary thyroid carcinoma in Chang Gung Memorial Hospital. 882 56

Sclerosing mucoepidermoid carcinoma with eosinophilia (SMECE) is a recently recognized malignant neoplasm of the thyroid gland. Two additional cases of this condition which occurred in a 70-year-old woman and a 69-year-old woman are presented. The case of the 70-year-old woman (patient 1) is the first report of distant metastasis, besides lymph node metastasis, for this type of tumor. The patient initially presented with a thyroid mass, and the thyroid gland with surrounding cervical lymph nodes was removed. Because of focal keratin "pearl" formation, the tumor was misinterpreted as a metastatic squamous cell carcinoma to the thyroid. Approximately 4 years later, the patient developed a left supraclavicular mass and lung densities. A pathological fracture of the right humeral head followed, and the left supraclavicular mass recurred along with newly developed subcutaneous nodules on the chest wall and arm. Open lung and bone biopsies revealed metastatic SMECE, which was morphologically identical to that of the thyroid mass. The 69-year-old woman (patient 2) had, in 1983, undergone thyroidectomy with left radical neck dissection; this had been diagnosed as follicular carcinoma of the thyroid with lymph node involvement. After multiple isolated lymph nodes metastases, the patient developed locally extensive, recurrent tumor that showed microscopic features of SMECE. Review of the previous thyroid tumor and lymph nodes revealed the same type of histology. To our knowledge, only a single report containing eight cases of this distinctive carcinoma of the thyroid has been published. Herein we describe characteristic morphological features of two additional cases of this rare malignancy, one with distant metastasis, and we review the related literature.
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PMID:Sclerosing mucoepidermoid carcinoma with eosinophilia of the thyroid: report of two patients, one with distant metastasis, and review of the literature. 930 35

The value of ultrasound in the diagnosis of a large rapidly growing thyroid mass was assessed in a study of 42 patients with a large (> 3 cm) rapidly growing (< two months) solitary mass. Haemorrhage into a thyroid nodule was present in 31 patients and thyroid malignancy in 11. Ultrasound of haemorrhage into a thyroid nodule revealed a large cystic mass in all 31 patients containing internal debris (22), septations (three), or a combination of both (six). The malignant causes of a large rapidly growing mass were lymphoma (two), anaplastic carcinoma (four) and metastasis (five). Ultrasound of these thyroid malignancies revealed a mass with a smooth, well-defined margin and strikingly low homogeneous echogenicity in all cases. Patients with thyroid metastases had evidence of widespread metastatic disease elsewhere. Lymphoma was differentiated from anaplastic carcinoma on fine-needle aspiration cytology or surgical biopsy. Ultrasound was of value in differentiating between a benign haemorrhagic nodule and a malignant tumour. The various malignant tumours had similar appearances, however, and could not be distinguished on ultrasound.
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PMID:The role of ultrasound in the diagnosis of a large, rapidly growing, thyroid mass. 933 26

A case of congenital thyroid teratoma with nodal spread is reported. Primary surgery was performed on a female infant on the 6th day of life. The thyroid mass was removed in toto, and an adjacent 1.2 cm lymph node was also removed. Histology showed solid and cystic teratoma with a variety of elements including prominent neurological tissue that was neuroblastoma-like in places. Residual compressed non-neoplastic thyroid tissue was identified in the subcapsular plane. The lymph node was largely replaced by neuroglial tissue that was cellular in some areas and showed intrasinusoidal growth and some mitotic activity. Recurrent cervical lymphadenopathy gradually developed, commencing a few months after surgery. Excision of cervical nodes was undertaken at 9 months of age. About 13 nodes up to 2 cm in diameter were excised. Most of the specimens consisted of reactive lymph nodes, but in three of the smaller nodes, there were subcapsular and sinusoidal masses of focally cellular neuroglial tissue, again with occasional mitoses. This tissue stained strongly for glial fibrillary acidic protein, in addition to expressing neural markers. The lymph node "deposits" were interpreted as "displaced" lesional tissue rather than metastases in the usual, aggressive sense. The girl remains well at 5 years of age.
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PMID:Congenital thyroid teratoma: a case with persistent neuroglial involvement of cervical lymph nodes. 1046 96

Follicle-derived thyroid cancer is rare in the young. The authors examined a population with a low rate of radiation exposure and who were treated at a single institution. The records of 56 patients diagnosed before the age of 25 years were analyzed. The majority of patients presented with an asymptomatic thyroid mass. All patients were treated surgically and half received postoperative ablation with 131I. Recurrent disease was detected in 29%. The presence of local metastases at initial surgery was a predictor of recurrence. No patient presented with distant metastases and no patient died of thyroid cancer. Although radiation exposure remains a risk factor for thyroid cancer in the young, only a minority of patients with thyroid cancer have a known history of exposure. Patients who are diagnosed at a young age have a high rate of long-term recurrence, and should be followed closely throughout their lives.
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PMID:Follicle-derived thyroid cancer in young people: the Duke experience. 1125 38

Although metastases to the thyroid are not uncommon at autopsy, most of these lesions are clinically occult. To our knowledge, this is the first report of a case of hepatocellular carcinoma initially presenting as a thyroid mass. Various radiological studies suggested malignant thyroid tumor, and core needle biopsy was performed. Metastasis from hepatocellular carcinoma was histopathologically suspected, and subsequent abdominal CT revealed advanced hepatocellular carcinoma.
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PMID:Thyroid metastasis from hepatocellular carcinoma as an initial presentation: a case report. 1130 18


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