Papillary Thyroid Carcinoma Presenting Research Articles

Papillary thyroid carcinoma presenting with upper respiratory tract obstruction and pulmonary metastases

Thyroid cancer is rare in children especially before the age of 10 years. Upper airway obstruction and pulmonary infiltration are rare manifestations of such tumor. An 8-year-old school girl was admitted to Mansoura University Children's Hospital for a papillary thyroid carcinoma manifested by severe upper respiratory tract obstruction. CT scan of the chest revealed multiple miliary shadows in both lungs. Total thyroidectomy was performed and pathological examination confirmed the diagnosis of papillary carcinoma of the thyroid gland. The patient received ablative dose of Iodine 131 and replacement therapy of L-thyroxine. Thyroid cancer, although rare, should be considered for differential diagnosis of upper airway obstruction and pulmonary metastases.

Cerebellar mass as a primary presentation of papillary thyroid carcinoma: case report and literature review

BackgroundPapillary carcinoma is the most common differentiated malignant thyroid neoplasm. The biological course of this cancer is typically indolent with a protracted clinical course. Metastases commonly occur in regional lymph nodes, and distant metastasis is a late and rare occurrence. We report a patient who presented with cerebellar metastasis prior to the diagnosis of papillary thyroid carcinoma and review the literature of brain metastasis from papillary thyroid carcinoma.ResultsA 75-year old female presented at the emergency room with progressive dizziness, headache and vomiting, where a brain CT and MRI showed a posterior cerebellar tumor. Surgical resection revealed papillary carcinoma consistent with thyroid origin. Subsequent ultrasound and CT-scan revealed a thyroid nodule, after which the patient underwent total thyroidectomy. Pathologic evaluation was consistent with papillary thyroid carcinoma.ConclusionBrain metastasis may rarely be the initial presentation of papillary thyroid carcinoma. Solitary brain metastasis can completely be resected with better prognosis.

Occult Papillary Thyroid Carcinoma Presenting as a Cystic Neck Mass

Occult Papillary Thyroid Carcinoma Presenting as a Cystic Neck Mass

An Unusual Imaging and Clinical Presentation of Papillary Thyroid Carcinoma

Papillary thyroid carcinoma is the most common thyroid malignancy, accounting for 88% of all thyroid cancers in the United States.' The most common clinical presentation is a solitary thyroid nodule. On high-resolution sonography, features suggestive of papillary thyroid carcinoma include a hypoechoic solid lesion with microcalcifications and intrinsic vascularity. 2-5 We report an atypical case of metastatic papillary thyroid carcinoma that presented as a left hip mass with unusual sonographic findings of a predominantly cystic primary thyroid lesion.

Occult Papillary Thyroid Carcinoma Presenting as Huge Cervical Metastasis with Cystic Pattern

Cervical cysts are usually benign in the population younger than 40 years. However, neck metastasis from malignancies of the head and neck may present as cervical cysts. Here, we report a case of papillary thyroid carcinoma with cervical metastasis and cystic change. A 35-year-old man visited our clinic, and his chief complaint was related to the presence of a huge neck mass for 15 years. Computed tomography scans revealed cystic masses and abnormal calcification in the thyroid gland. Fine needle aspiration cytology of the left thyroid gland revealed atypical cells with a few cells harboring intranuclear pseudoinclusion. We then performed dissection of the left side of the neck to remove the cystic masses and a left thyroid lobectomy. Intraoperative frozen section biopsy of the cystic masses showed benign cystic lesions. However, the results of the final pathologic examination proved thyroid papillary carcinoma in the thyroid gland and the cystic masses. The patient received dissection of the right side of the neck accompanied by right thyroid lobectomy. After the operation, 131I ablation therapy was performed. There was no recurrence noted during the regular 2-year follow-up period.

Lingual Thyroid Carcinoma With Nodal Metastasis

To discuss treatment options and surgical management of lingual thyroid carcinoma with cervical metastasis. Lingual thyroid is relatively uncommon, and carcinoma of the lingual thyroid is extremely rare, with only 40 cases reported. We report a new case of a young female who presented with a cervical neck mass found to represent metastatic papillary thyroid carcinoma. Further workup revealed the patient's only thyroid tissue was located at the tongue base and was the site of the primary tumor. Management of lingual thyroid carcinoma and review of the literature is discussed. A case report and review of the literature of lingual thyroid carcinoma. A young female presented with a left neck mass diagnosed as metastatic papillary thyroid carcinoma. Review of the computed tomography scan of the neck revealed a tongue base mass, absence of an othotopic thyroid gland and bilateral cervical lymphandenopathy. Bilateral selective neck dissections with removal of the tongue base lesion confirmed the diagnosis of lingual thyroid carcinoma with multiple left cervical nodal metastases. A case of lingual papillary thyroid carcinoma with cervical metastasis is reported. Treatment is best managed with surgical excision of all thyroid tissue followed by radioactive iodine ablation. Surgical approaches to the tongue base need to be considered based on the size of the lingual primary tumor and the need to address lymph node metastases gland. This is the first reported case in the literature of lingual papillary thyroid carcinoma presenting with cervical nodal metastasis in a female with absence of an orthotopic thyroid gland. This is also the first report to show that papillary and not follicular cell carcinoma is the predominating histopathology in lingual thyroid carcinoma.

Aggressive Presentation of Papillary Thyroid Carcinoma: Where Has the Vertebra Gone?

Aggressive Presentation of Papillary Thyroid Carcinoma: Where Has the Vertebra Gone?

Metastatic Papillary Thyroid Carcinoma Presenting as a Long-Standing Calcified Neck Mass

Metastatic Papillary Thyroid Carcinoma Presenting as a Long-Standing Calcified Neck Mass

Thyroid Cancer Presenting as a PET Incidentaloma in a Patient With Concomitant Breast Cancer Metastases to the Thyroid

Metastases to the thyroid gland are considered a rare cause of thyroid tumor. Furthermore, a relationship between breast and thyroid carcinoma has been previously proposed. We describe the case of a 59-year-old woman who presented with simultaneous papillary and breast carcinoma within the thyroid gland. F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) done for the evaluation of her metastatic breast cancer revealed a thyroid incidentaloma with a high metabolic rate (standardized uptake value [SUV] of 13). She underwent thyroidectomy and the pathology revealed papillary thyroid carcinoma corresponding to the lesion visualized on FDG PET. However, small metastatic implants of breast carcinoma were seen within the opposite thyroid lobe. This is a rare description of a concomitant papillary thyroid carcinoma presenting as an FDG PET incidentaloma alongside breast cancer metastases to the thyroid gland. Thyroid and breast cancer sometimes occur in the same patient. However, no explanation has been found to link these 2 cancers. Although uncommon, FDG PET thyroid incidentalomas seem to harbor a higher rate of malignancy than incidentalomas found on conventional imaging. In the appropriate clinical setting, it is therefore suggested to investigate these lesions thoroughly.

Papillary thyroid carcinoma presenting as a solitary soft tissue arm metastasis in an elderly hyperthyroid patient. Case report and review of the literature

A case of papillary thyroid carcinoma (PTC) presenting as a solitary metastasis in the right arm muscle is described in an elderly hyperthyroid male patient. A 2-cm nodule in the right bycipites muscle was found to be a papillary carcinoma of thyroid origin and a primary, 3.5-cm tumor was subsequently found in the left lobe of a hyperfunctioning gland due to toxic goiter. Both tumors were well differentiated PTC, follicular variant. No high grade features, nor extrathyroidal spread, nor regional lymph node metastases were found, but histology evidenced intrathyroidal vascular invasion. After radical surgery and radioiodine therapy, the patient is currently disease-free 4 years after diagnosis. This is the third reported case of PTC manifesting as a single soft tissue metastasis and the first associated with hyperthyroidism. Hematogenous spread of differentiated PTC is rare, although less unusual in PTC follicular variant. Histological vascular invasion, hypervascularity and increased blood flow in the hyperfunctioning thyroid gland might have facilitated the dissemination of malignant tumor cells through the bloodstream. Literature data indicate that PTC in elderly patients is increasing and is often clinically aggressive. Radical surgical and radiometabolic treatments are required also in this age group to improve clinical outcome.

Papillary Thyroid Carcinomas with Lung Metastases

Limited information is available on the presentation, treatment outcomes, and prognostic factors of papillary thyroid carcinoma with lung metastases. This study retrospectively analyzed the data of 2003 patients with thyroid cancer who were treated and followed up at Chang Gung Memorial Hospital from January 1979 to December 2002. In total, 1516 papillary thyroid carcinomas were enrolled. One hundred two (6.7%) papillary thyroid carcinomas with lung metastases were followed including 57 women with mean age of 41.7 +/- 17.3 years and 45 men with mean age of 49.6 +/- 17.2 years. These patients included 52 patients with papillary thyroid carcinoma who presented with lung metastases at the time of diagnosis. The 102 cases of papillary thyroid carcinomas with lung metastases included 72 cases with lung metastases only, and 30 cases with other organ involvement. After mean follow-up periods of 8.8 +/- 0.6 years, 28 (27.5%) of the patients with lung metastasis died, while 6 improved to clinical stage I. The 5-, 10-, 15-, and 20-year survival rates in patients with papillary thyroid carcinoma without distant metastasis and in the lung metastases groups were 99.0%, 98.5%, 98.0%, 98.0%, and 91.3%, 75.0%, 64.0%, 51.2%, respectively. Comparing the Kaplan-Meier survival curves between the patients with papillary thyroid carcinomas with lung metastases only and those with multiorgan metastases demonstrates no statistically significant difference in mortality rates. However, age, gender, postoperative thyroglobulin (Tg) level and tumor size displayed statistically significant differences between the lung metastases and no distant metastasis groups. Fifty of the 102 patients with papillary thyroid carcinomas with lung metastases developed lung metastases during follow-up. Larger amounts of remnant thyroid tissues with higher Tg levels were noted in these patients compared to those without distant metastasis. The prognosis of patients with papillary thyroid carcinoma with lung metastases at time of diagnosis is the same as for those whose lung metastases are discovered later. Survival analysis demonstrates no difference between lung metastases and multiorgan metastases.

Pericardial tamponade as initial presentation of papillary thyroid carcinoma

We herein describe a 19-year-old woman who presented with pericardial effusion that resulted in heart tamponade. The clinicopathological study revealed papillary carcinoma of the thyroid metastasized to the heart. Although malignant pericardial effusion is a known complication of thyroid cancer, it is rarely the first manifestation and shows a relatively favourable prognosis despite widespread metastases if adequate treatment is given.

Intrathyroideal Papillary Thyroid Carcinoma Presenting with a Solitary Brain Metastasis

Papillary thyroid carcinoma (PTC) is the most common type of well-differentiated thyroid carcinoma and typically has an excellent prognosis. The incidence of distant metastasis from PTC is low. However, once metastasis has developed in a distant site, prognosis is markedly diminished. Brain metastases from PTC are extremely rare. No consensus regarding management has yet been reached. We report on the case of a patient who presented with signs of intracranial hypertension. Cranial magnetic resonance imaging (MRI) identified a lesion of the right temporofrontoparietal lobe. The patient underwent a craniotomy with a total removal of the tumor. Histologic examination of the lesion showed a metastasis of papillary adenocarcinoma. We observed a cold nodule in the right lobe of the thyroid on physical examination and imaging techniques (e.g., CT and scintigraphy). Fine-needle-aspiration cytology of the nodule was reported as PTC. A total thyroidectomy was performed and histopathological examination showed intrathyroidal variant of PTC. Postoperatively adjuvant whole brain radiation therapy with 44 Gy to multiple brain metastases of PTC was applied. One month later, the patient then underwent 131I radioiodine therapy with 150 mCi of 131I given orally. In conclusion, the present case underwent an aggressive multimodal approach to therapy. This report indicates that the early detection and control of brain metastases may contribute to a better quality of life for patients affected by brain metastases.

Maxillary mass as the presenting manifestation of papillary thyroid carcinoma

A case of follicular variant of papillary thyroid carcinoma presenting with a right maxillary mass is described. This is perhaps the first instance of maxillary metastasis from papillary thyroid carcinoma.

Coexistent Hashimoto's thyroiditis with papillary thyroid carcinoma: impact on presentation, management, and outcome.

This study was performed to assess the relationship between Hashimoto's thyroiditis and the development, presentation, management, and outcome of papillary thyroid carcinoma. Two complementary analytic methods were used. The clinical study was a retrospective case-control study, including patients seen with papillary thyroid carcinoma presenting during a 12-year period. We also used a systematic literature review to identify suitable reports and meta-analysis to statistically combine published results. The prevalence of Hashimoto's thyroiditis is significantly higher in patients with papillary thyroid cancer (odds ratio, 1.89; 95% CI, 1.02-3.50). These patients typically have a dominant nodule, 44% of which are discovered incidentally on routine examinations. Fine-needle aspiration has a sensitivity of 91% for the identification of papillary cancer. The prognostic variables at the time of a diagnosis of papillary cancer and the approach to management are not altered by the presence of coexistent Hashimoto's thyroiditis. In addition, the rate of surgical complications was not higher in patients with coexistent Hashimoto's disease. Meta-analysis suggested a positive correlation between Hashimoto's disease and disease-free survival (r = 0.09; 95% CI, 0.05-0.12) and overall survival (r = 0.11; 95% CI, 0.07-0.15). There is an increased prevalence of Hashimoto's thyroiditis in patients with papillary thyroid carcinoma. The presence of coexistent Hashimoto's thyroiditis does not affect the diagnostic evaluation or management of papillary thyroid cancers. The survival of patients who have papillary thyroid cancers may be superior in coexistent Hashimoto's thyroiditis.

Occult papillary thyroid carcinoma presenting as a parapharyngeal metastasis

The neoplastic involvement of the parapharyngeal space is a rare condition that represents only 0.5% of all head and neck tumors.1-3 The benign salivary gland tumors and tumors of neural tissue origin constitute the great majority of these cases. 3-6 To encounter a metastatic thyroid cancer in the parapharyngeal space is an extremely unusual occurrence. The literature review showed only six cases published previously.7-*2 In this article, we report a patient presenting with a left parapharyngeal mass. The pathological examination showed a metastatic thyroid papillary cancer. Besides the unusual localization of the lesion, this case also confirms the anatomic study of Rouviere13 showing the existence of lymphatic channels between the thyroid lymphatics and the parapharyngeal space.

Metastatic papillary thyroid carcinoma presenting as a retropharyngeal mass

Although papillary thyroid carcinoma may present as a lateral neck mass in 10% to 21% of the cases, it is rare for this disease to metastasize to the retropharyngeal space and initially present as an oropharyngeal mass.1-3 The differential diagnosis of lesions of the retropharyngeal spaces is quite lengthy. However, the most common lesions are inflammatory conditions such as cellulitis, abscess, and suppurative adenopathy. Malignancies, such as squamous cell carcinoma and non-Hodgkin’s lymphoma, may occur in the retropharyngeal space as a result of direct extension or nodal metastasis.4 The retropharyngeal location of a lesion is suggested by anterior displacement of the parapharyngeal fat on computed tomography (CT) or magnetic resonance imaging (MRI). Preoperative diagnosis of these lesions using fine-needle aspiration can be hindered by the adjacent neurovascular structures. The few case reports of such rare presentations of metastatic papillary thyroid carcinoma are pre-1985 and, therefore, do not address MRI findings. In this article, we report a case of metastatic papillary thyroid carcinoma initially presenting as a retropharyngeal mass. Characteristic MRI findings of papillary carcinoma elsewhere in the neck are discussed and compared with this case. This rare metastasis is presented to highlight those features that

Papillary thyroid carcinoma presenting with massive angioinvasion of the great vessels of the neck and chest

Papillary thyroid carcinoma presenting with massive angioinvasion of the great vessels of the neck and chest

Papillary Thyroid Carcinoma Presenting with Massive Angioinvasion of the Great Vessels of the Neck and Chest

Papillary Thyroid Carcinoma Presenting with Massive Angioinvasion of the Great Vessels of the Neck and Chest

112: Papillary Thyroid Carcinoma Presenting with Massive Angioinvasion of the Great Vessels of the Neck and Chest

112: Papillary Thyroid Carcinoma Presenting with Massive Angioinvasion of the Great Vessels of the Neck and Chest