Metastases to the thyroid gland: review of incidence, clinical presentation, diagnostic problems and surgery, our experi
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SHORT REVIEW
Metastases to the thyroid gland: review of incidence, clinical presentation, diagnostic problems and surgery, our experience E. Battistella1 · L. Pomba1 · G. Mattara1 · B. Franzato1 · A. Toniato1 Received: 11 March 2020 / Accepted: 27 April 2020 © Italian Society of Endocrinology (SIE) 2020
Abstract Purpose Metastases to the thyroid gland are uncommon and they represent 1–3% of all thyroid malignancy. The aim of this study is to analyze the diagnostic problems and the role of surgery in metastatic lesions to the thyroid. Methods We retrospectively analyzed all patients who had undergone thyroidectomy at our Center. Out of more than 5000 thyroidectomies performed, only 9 cases had metastases to the thyroid gland. Results The most common primary tumor arises from kidney and lung. Non-thyroid malignancies diagnosis was obtained with US, FNAC and PET–CT. Surgery was performed in all our series (except for one case) and the expectancy of life after surgery is related to the primary tumor and comorbidities of patients. Conclusion The thyroid gland can be a rare site of metastases for many tumors, especially in an abnormal thyroid gland. Surgery is associated with an improved survival and the extension of surgery depends on the extension of the neoplastic lesion. Keywords Thyroid gland · Thyroid malignancy · Metastases · Non-thyroid malignancy · Survival
Introduction Metastases to the thyroid gland from non-thyroid sites are uncommon but not rare. In the literature, it has been reported in only 1–3% of all patients who have surgery for thyroid malignancy. However, the rate of incidence in autopsy studies has been variable from 1.9 to 26.4% among patient dying with cancer [1, 2]. In more than 5000 thyroidectomies over a period of 11 years, only 9 cases were found to be metastases to the thyroid gland. Metastases to the thyroid gland has been reported in renal cell carcinoma (RCC), breast cancer, lung cancer, gastrointestinal malignancies, malignant melanoma, sarcoma, hematologic malignancies, and other genitourinary cancers. The concomitance of thyroid goiter and lack of symptoms can frequently cause problems of diagnosis and treatment, which is why the rate of thyroid metastases at the clinical observation is between 0.006 and 0.3% [3]. Occasionally, symptoms of dysphagia, dyspnea, and hoarseness may be reported [1–3]. * E. Battistella [email protected] 1
Endocrine Surgery Unit, Department of Surgery, Veneto Institute of Oncology, Padua, Italy
The aim of this study is to examine the diagnostic problems, the importance of the cytology and the role of the surgery.
Clinical records From 2007 to 2018, we performed more than 5000 thyroidectomies, and we detected only 9 patients (7 males, 2 female) with non-thyroid metastases (0.18% among all thyroidectomies). The average age of the 9 cases at the time of diagnosis of the thyroid metastases was 68 years (range 48–87 years old). The thyroid metastases were identified on average 39.5 months (range 2–96 months) after surgery of the pri
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