Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hemangioendotheliomas of the thyroid are neoplasms that are rarely encountered in the Alpine region in Europe. The endemic goiter in this iodine-deficient region can be considered as a predisposing factor. We report the second case of an epithelioid hemangioendothelioma (EHE) of the thyroid gland and the first clinical case with malignant behavior. A 73-year-old woman with a long history of multinodular goiter presented with a rapidly growing thyroid mass, free of distant metastases. A total thyroidectomy was performed. Histologically the lesion had characteristic epithelioid and spindle cell proliferation in a background of chondromyxoid stroma. Cytoplasmic vacuolization in the epithelioid and spindle cells were present. Tumor cells were positive for factor VIII-related antigen, MNF116, PAN-ceratin, CD 34, and CD 31 and negative for cytokeratin allowing the diagnosis of EHE. Nine months after the primary resection the tumor locally recurred. A palliative resection was performed in a second operation followed by interferon-alpha therapy. The patient rapidly developed a second local relapse and died 13 months after the diagnosis of an EHE had been made. An improvement of the very poor prognosis of this rare tumor may depend on early tumor diagnosis and surgery combined with a multimodal treatment.
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PMID:An authentic malignant epithelioid hemangioendothelioma of the thyroid: a case report and review of the literature. 1640 12

Metastasis to the thyroid occur infrequently. The overall incidence in autopsy series vary from 0-5% in unselected cases to 24% in patients with a known malignancy. They usually occur when there are another metastases, sometimes many years after diagnosis of the original primary tumour. We present the case of a woman with dysphagia and dysphonia due to a thyroid mass as first manifestation of a metastatic breast cancer.
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PMID:Dysphagia and dysphonia in a woman with a previous breast cancer. 1687 May 43

It has been reported that the thyroid is relatively immune to malignant metastasis. Therefore, in a practical setting, it is difficult to diagnose whether synchronous nodules in both lung and thyroid are independent or have metastasized from one to the other. In the present study, we report a treatment approach in a patient with such nodules, using a molecular technique. A 68-year-old woman presented with synchronous solitary thyroid mass and a nodular lesion in the right lung. Both tumors, which were surgically resected, morphologically showed neuroendocrine differentiation, which was confirmed by immunohistochemical analysis. These features required differential diagnosis from possible (1) medullary thyroid carcinoma (MTC) with metastasis to the lung, (2) pulmonary neuroendocrine carcinoma with metastasis to the thyroid, and (3) independent MTC and pulmonary neuroendocrine carcinoma. Identical mutations of the p53 gene were detected in both the thyroid and lung tumors, indicating the same origin for both tumors. In addition, these mutations and a lack of calcitonin expression suggested a pulmonary origin of the tumors. Metastatic thyroid cancers are well known to cause miliary lesions in the lung, while lung cancers can metastasize to various tissues. Furthermore, pulmonary neuroendocrine carcinoma has been reported as having a tendency of metastasizing to the thyroid. Head and neck surgeons should be aware that a particular subset of lung cancers may develop a metastatic solitary nodule in the thyroid, as presented. An effective therapeutic strategy is largely dependent on the differential diagnosis.
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PMID:Neuroendocrine tumor metastasis to the thyroid gland. 1738 Apr 45

Metastatic disease to the thyroid is not an unusual finding at autopsies, but it is rare to be found in clinical situations. We present the first case of adenocarcinoma of the proximal esophagus presenting as a thyroid mass in a young healthy patient without any previous history of malignancy. This case highlights the importance of thorough work-up when addressing a thyroid mass. A high index of suspicion should be maintained in order to be able to detect unusual etiologies of thyroid conditions, especially when histopathology is not characteristic for primary thyroidal malignancies.
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PMID:Proximal esophageal adenocarcinoma presenting as a thyroid mass: case report and review of the literature. 1738 61

Anaplastic thyroid carcinoma may represent the ultimate dedifferentiation step of thyroid tumorigenesis and is one of the poorest cancers in human. It accounts for less than 2% of thyroid cancers and affects older patients in their sixth to eighth decade. Usual clinical presentation is a rapidly growing thyroid mass invading surrounding structures with compressive symptoms. Cervical lymph nodes enlargement and distant metastases occur frequently. Though cytological results obtained by fine needle aspiration may be suggestive of diagnosis, tissue biopsy for immunohistochemical study can be necessary to exclude lymphoma and to validate aggressive therapies. Patients developing anaplastic thyroid cancer must be referred urgently in cancer centers to plan multimodality therapeutic approach depending on their performance status. The treatment regimen combines surgery when feasible, hyperfractionated and accelerated external beam radiotherapy and doxorubicin based chemotherapy. Such treatment can provide control of locoregional disease but does not impact on overall survival in patients with distant metastases. The prognosis is dismal with a mean survival of four to nine months after diagnosis. Long survivors are patients with emerging disease presenting a resectable tumor and receiving adjuvant radiotherapy and/or chemotherapy. Therapeutic researches investigate redifferenciation strategies and targeted therapies to inhibit EGF receptors and neoplastic angiogenesis. Primary prevention of this lethal disease may consist of adequate treatment of differentiated thyroid cancers and goiters in elderly.
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PMID:[Anaplastic thyroid carcinoma]. 1842 22

Spindle epithelial tumor with thymus-like differentiation (SETTLE) of the thyroid is a rare tumor that occurs habitually in children and young adults. To date, about 20 cases of SETTLE have been reported in the English medical literature. It is considered to be a tumor of low malignancy with a favorable outcome, but delayed blood-borne metastases have been reported (sometimes over 20 years after initial treatment). In the current report, the authors describe an interesting case of SETTLE in a young woman. Double phase Tc-99m tetrofosmin scintigraphy showed accumulation of the tracer in the thyroid mass.
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PMID:Spindle epithelial tumor with thymus-like differentiation of the thyroid. 1903 99

The thyroid gland is a relatively uncommon site for a secondary malignancy; even less common is a case of malignant melanoma metastatic to the thyroid. We describe the case of a 68-year-old man who presented with a neck mass in the posterior triangle. Fine-needle aspiration biopsy (FNAB) identified the mass as a malignant melanoma. The patient had had no known primary skin melanoma. He underwent a left modified radical neck dissection, and the mass was discovered to be a positive lymph node. Postoperatively, he declined to undergo radio- and chemotherapy. Eighteen months later, he returned with a diffusely enlarged thyroid. FNAB again attributed the enlargement to malignant melanoma. Soon thereafter, the patient began experiencing seizures, and on magnetic resonance imaging, he was found to have metastatic disease to the brain. He developed ventilator-dependent respiratory failure and required a subtotal thyroidectomy for the placement of a tracheostomy tube. Patients who present with a thyroid nodule and who have a history of malignancy present a diagnostic dilemma: Is the nodule benign, a new primary, or a distant metastasis? The findings of this case and a review of the literature strengthen the argument that any patient with a thyroid mass and a history of malignancy should be considered to have a metastasis until proven otherwise.
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PMID:Malignant melanoma metastatic to the thyroid gland: a case report and review of the literature. 1917 60

Because benign-appearing thyroid nodules with metastasis are very rare, the author reports herein four thyroid nodules (one follicular adenoma and three adenomatous nodules) with brain metastasis. A 75-year-old Japanese woman was admitted to our hospital because of thyroid mass. Imaging modalities revealed four distinct nodules in the thyroid, and tumorectomies of all nodules were performed under the clinical diagnosis of benign thyroid nodules. Grossly, one of them was a completely encapsulated tumor (35 mm in diameter). Other three nodules were non-encapsulated nodules (10 mm, 8 mm, and 7 mm in diameters). Multiple sections were obtained from the largest nodule. One section was obtained from each of the smaller three nodules. Microscopically, the largest tumor was an encapsulated follicular adenoma. The tumor consisted of normofollicles and microfollicles surrounded by a fibrous capsule. Neither capsular invasion nor vascular permeation was recognized. The parenchyma lacked nuclear atypia, mitotic figures, degenerative changes, papillary structures, nuclear inclusions, nuclear ground-glass features, and nuclear grooves. Thus, the largest tumor was diagnosed as follicular thyroid adenoma. The remaining three small nodules were typical adenomatous nodules composed of normofollicles and macrofollicles without nuclear atypia, mitotic figures, degenerative changes, papillary structures, nuclear inclusions, nuclear ground-glass features, and nuclear grooves. Therefore, a diagnosis of adenomatous nodules (goiters) was made. However, six years later, the patient showed a brain metastasis of thyroid tumor composed of macrofollicles without cellular and nuclear atypia. A diagnosis of metastatic follicular thyroid carcinoma was made. The present case suggests that benign thyroid nodules can metastasize.
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PMID:Brain metastasis from thyroid adenomatous nodules or an encapsulated thyroid follicular tumor without capsular and vascular invasion: a case report. 1982 30

Cancer metastasis to the thyroid is extremely rare. The more commonly reported primary sites for metastasis to the thyroid are the kidney, breast, lung, colon, esophagus, and uterus. Thyroid metastasis from the stomach has only been reported in three cases. Herein, we report a 71-year-old man presenting with bilateral thyroid multinodular lesions. Bilateral near-total thyroidectomy was performed due to airway compression with related symptoms. Wedge resection of a suspicious pulmonary nodule, detected on CT, was performed for diagnosis. Polypoid lesions in the stomach were examined by trans-scopic biopsy. Poorly differentiated adenocarcinomas with the same histological profiles were noted at these three sites. The immunohistochemical staining for thyroglobulin of these specimens was negative. We conclude that a new thyroid mass appearing in a patient with present or prior malignancies should raise the concern of metastatic disease.
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PMID:Metastasis of gastric carcinoma to the thyroid and lung: a case report and review of literature. 2059 21

Spindle epithelial tumor with thymus-like element (SETTLE) is a rare malignant neoplasm of the thyroid, occurring predominantly in children, adolescents, and young adults. SETTLE usually presents itself as a thyroid mass, without metastases at diagnosis. It is believed to derive from branchial pouch or thymic remnant tissue showing primitive thymic differentiation. This article reports the clinical, cytological, histological and immunohistochemical features of a SETTLE in a 3-year-old girl. Microscopic exam revealed a nodular, highly cellular neoplasm displayed in the classic biphasic pattern, with mixture of prominent spindle cell component and a minor glandular component lined by mucinous or respiratory-type epithelium. The immunohistochemical study showed strong and diffuse positivity for pan-CK, vimentin and smooth muscle actin. The present case is the first SETTLE case reported in Brazil. To date, the patient described remains without evidence of recurrence or metastasis 5 years after surgery.
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PMID:Thyroid spindle epithelial tumor with thymus-like differentiation (SETTLE): case report and review. 2108 72


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