Vol 7, No 2 (2005)
Published online: 2005-09-06
Malignant neoplasm metastases to thyroid gland - personal remarks
Chirurgia Polska 2005;7(2):80-84.
Abstract
Background: This paper aims to present individual observations regarding neoplasmatic metastases moving
to the thyroid gland, their clinical picture, treatment and prognosis.
Material and methods: In the Clinic of General Surgery in Bytom during 1990-2003, 11,490 patients underwent surgery because of different forms of goiter, where 561 (4.9%) patients were diagnosed with malignant neoplasm, and in the cases of 8 patients (0.07% of all of whom were operated on and 1.4% of those with malignant neoplasm) the presence of neoplasmatic metastasis of the thyroid was confirmed. All of these patients underwent an assessment of thyroid activity and the structure of the gland through ultrasonograph (USG) and scintigraph examinations. Patients were operated on under general endotracheal anesthesia with on the spot microscopic examination.
Results: Metastasis of kidney clear cell carcinoma to the thyroid was confirmed in the cases of 6 (75%) patients - at the latest 10 years after operating on the primary tumor. In the cases of 2 (25%) patients the primary focus of the metastasis constituted breast and lung carcinoma. All patients were diagnosed with an enlarged goiter; in 3 cases signs of superior caval vein syndrome were noted. There were no disturbances of hormonal activity. Results of pre-operational aspiration thin-needle biopsy did not confirm the final diagnosis. A full thyroidectomy was possible in the cases of 5 patients. In 3 cases progression of changes allowed only a partial resection of the goiter and in 1 case a tracheostomy was necessary. A final diagnosis was agreed only after a microscopic examination employing the paraffin technique.
Conclusions: 1. Metastases moving from a malignant neoplasm to the thyroid gland are rare and their pre-operational diagnosis is very difficult. 2. Clear cell carcinoma of the kidney constitutes a particularly frequent source of metastases to the thyroid, even many years after an operation on the primary tumor.
Material and methods: In the Clinic of General Surgery in Bytom during 1990-2003, 11,490 patients underwent surgery because of different forms of goiter, where 561 (4.9%) patients were diagnosed with malignant neoplasm, and in the cases of 8 patients (0.07% of all of whom were operated on and 1.4% of those with malignant neoplasm) the presence of neoplasmatic metastasis of the thyroid was confirmed. All of these patients underwent an assessment of thyroid activity and the structure of the gland through ultrasonograph (USG) and scintigraph examinations. Patients were operated on under general endotracheal anesthesia with on the spot microscopic examination.
Results: Metastasis of kidney clear cell carcinoma to the thyroid was confirmed in the cases of 6 (75%) patients - at the latest 10 years after operating on the primary tumor. In the cases of 2 (25%) patients the primary focus of the metastasis constituted breast and lung carcinoma. All patients were diagnosed with an enlarged goiter; in 3 cases signs of superior caval vein syndrome were noted. There were no disturbances of hormonal activity. Results of pre-operational aspiration thin-needle biopsy did not confirm the final diagnosis. A full thyroidectomy was possible in the cases of 5 patients. In 3 cases progression of changes allowed only a partial resection of the goiter and in 1 case a tracheostomy was necessary. A final diagnosis was agreed only after a microscopic examination employing the paraffin technique.
Conclusions: 1. Metastases moving from a malignant neoplasm to the thyroid gland are rare and their pre-operational diagnosis is very difficult. 2. Clear cell carcinoma of the kidney constitutes a particularly frequent source of metastases to the thyroid, even many years after an operation on the primary tumor.
Keywords: thyroid glandneoplasm metastasesthyroid malignant neoplasmafollicular tumor
