Basic & Clinical Cancer Research 2017. 9(4):32-39.

Papillary Thyroid Carcinoma with Thigh Muscle Metastases and Dramatic Response to Radiation and Targeted Therapy: a case report and review of The literature
Reza Ghalehtaki, Maisa Yamrali, Borna Farazmand, Armaghan Fard-Esfahani, Kamran Alimoghaddam, Peiman Haddad

Abstract


Soft tissue metastases are extremely rare in differentiated thyroid cancers. We hereby present a man with a history of papillary thyroid cancer (PTC) at the age of 46, who was referred to cancer Institute due to raised serum thyroglobulin (Tg) and a new mass in the thigh. Imaging studies were suggestive of recurrence of the disease in the tumor bed, neck nodes and lungs, and also a mass in his left thigh, based on positron emission tomography (PET) scan, without radioactive iodine uptake. The excision of the mass revealed metastatic PTC. After management of symptomatic local recurrence with external beam radiotherapy (EBRT), he received sorafenib. After three years he is doing well and serum Tg is stable. 


Keywords


Papillary thyroid cancer; muscle metastases; FDG-P

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References


Sakamoto A. Definition of poorly differentiated carcinoma of the thyroid: the Japanese experience. Endocr Pathol. 2004;15(4):307–11.

Nishida T, Katayama S, Tsujimoto M, Nakamura J, Matsuda H. Clinicopathological significance of poorly differentiated thyroid carcinoma. Am J Surg Pathol. 1999;23(2):205–11.

Pacini F, Schlumberger M, Dralle H, Elisei R, Smit JWA, Wiersinga W. European consensus for the management of patients with differentiated thyroid carcinoma of the follicular epithelium. Eur J Endocrinol. 2006;154(6):787–803.

Jukkola A, Bloigu R, Ebeling T, Salmela P, Blanco G. Prognostic factors in differentiated thyroid carcinomas and their implications for current staging classifications. Endocr Relat Cancer. 2004;11(3):571–9.

Haq M, Harmer C. Differentiated thyroid carcinoma with distant metastases at presentation: prognostic factors and outcome. Clin Endocrinol (Oxf). 2005;63(1):87–93.

Khorjekar GR, Klubo-Gwiezdzinska J, Van Nostrand D, Wartofsky L. A Summary of Rare Sites of Metastasis Secondary to Differentiated Thyroid Cancer. In: Thyroid Cancer [Internet]. New York, NY: Springer New York; 2016 [cited 2017 Oct 13]. p. 735–44. Available from: http://link.springer.com/10.1007/978-1-4939-3314-3_66

Califano I, Quildrian S, Coduti M, Rojas Bilbao E, Otero J, Califano L. Soft tissue metastases from differentiated thyroid cancer diagnosed by 18F FDG PET-CT. Arq Bras Endocrinol Metabol [Internet]. 2013 Jun [cited 2017 Oct 13];57(4):317–21. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27302013000400007&lng=en&tlng=en

Nixon IJ, Whitcher MM, Palmer FL, Tuttle RM, Shaha AR, Shah JP, et al. The impact of distant metastases at presentation on prognosis in patients with differentiated carcinoma of the thyroid gland. Thyroid. 2012;22(9):884–9.

Goffredo P, Sosa JA, Roman SA. Differentiated thyroid cancer presenting with distant metastases: a population analysis over two decades. World J Surg. 2013;37(7):1599–605.

Bruglia M, Palmonella G, Silvetti F, Rutigliano P, Criante P, Marmorale C, et al. Skin and thigh muscle metastasis from papillary thyroid cancer. Singapore Med J. 2009;50(2):e61-4.

Farina E, Monari F, Tallini G, Repaci A, Mazzarotto R, Giunchi F, et al. Unusual thyroid carcinoma metastases: a case series and literature review. Endocr Pathol. 2016;27(1):55–64.

Song H-J, Xue Y-L, Xu Y-H, Qiu Z-L, Luo Q-Y. Rare metastases of differentiated thyroid carcinoma: pictorial review. Endocr Relat Cancer. 2011;18(5):R165–74.

Iwai H, Ohno Y, Ito H, KIYOKAWA T, AOKI N. Renal rupture associated with a poorly differentiated follicular thyroid carcinoma metastasizing to the thigh muscle, lung and kidney. Intern Med. 2005;44(8):848–52.

Xue Y-L, Song H-J, Qiu Z-L, Luo Q-Y. Large Thigh and Buttock Muscle Metastases as the Initial Manifestation of Follicular Thyroid Cancer. Clin Nucl Med. 2014;39(4):363–4.

Seely S. Possible reasons for the high resistance of muscle to cancer. Med Hypotheses. 1980;6(2):133–7.

Luo Q, Luo Q, Sheng S, Chen L, Yu Y, Lu H, et al. Localization of concomitant metastases to kidney and erector spinae from papillary thyroid carcinoma using 131I-SPECT and CT. Thyroid. 2008;18(6):663–4.

Yang J, Li L-F, Zhang X-M, Xu Q, Zhang J, Weng W-W, et al. Unusual synchronous skeletal muscle and lung metastasis in papillary thyroid cancer: A case report and review of the literature. Oncol Lett. 2015;9(2):727–30.

Surov A, Hainz M, Holzhausen H-J, Arnold D, Katzer M, Schmidt J, et al. Skeletal muscle metastases: primary tumours, prevalence, and radiological features. Eur Radiol. 2010;20(3):649–58.

Plaza JA, Perez‐Montiel D, Mayerson J, Morrison C, Suster S. Metastases to soft tissue. Cancer. 2008;112(1):193–203.

Pretell-Mazzini J, de Neyra JZS, Luengo-Alonso G, Shemesh S. Skeletal muscle metastasis from the most common carcinomas orthopedic surgeons deal with. A systematic review of the literature. Arch Orthop Trauma Surg. 2017;1–13.

Dong M-J, Liu Z-F, Zhao K, Ruan L-X, Wang G-L, Yang S-Y, et al. Value of 18F-FDG-PET/PET-CT in differentiated thyroid carcinoma with radioiodine-negative whole-body scan: a meta-analysis. Nucl Med Commun. 2009;30(8):639–50.

Pace L, Nicolai E, Klain M, Salvatore M. Diagnostic value of FDG PET/CT imaging. Q J Nucl Med Mol Imaging. 2009;53(5):503.

Bae SY, Lee SK, Koo MY, Hur SM, Choi M-Y, Cho DH, et al. Distant, solitary skeletal muscle metastasis in recurrent papillary thyroid carcinoma. Thyroid. 2011;21(9):1027–31.


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