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Clinicoradiological characteristics of patients with differentiated thyroid carcinoma and renal metastasis: case series with follow up

Published online by Cambridge University Press:  30 January 2014

P Kand
Affiliation:
Radiation Medicine Centre (BARC), Tata Memorial Centre Annexe, Mumbai, India
S Basu*
Affiliation:
Radiation Medicine Centre (BARC), Tata Memorial Centre Annexe, Mumbai, India
*
Address for correspondence: Dr Sandip Basu, Radiation Medicine Centre (BARC), T M C Annexe, Jerbai Wadia Rd, Parel, Mumbai 400012, India Fax: +91 (0)22 24157098 E-mail: [email protected]

Abstract

Background:

Renal metastasis is relatively unusual in patients with differentiated thyroid carcinoma.

Methods:

The clinicoradiological parameters of a series of patients with differentiated thyroid carcinoma and renal metastasis were assessed, together with follow-up data.

Results and conclusion:

The series comprised 4 male patients over the age of 45 years with extensive disease at the primary site. Retro-sternal extension of a large goitre was observed in three patients. The primary tumour was 4 cm or larger in all patients (range, 4–14 cm), and three patients had associated lymph node metastasis. None had any genito-urinary symptoms at presentation. Two patients had isolated renal metastases with no other distant metastases, while the others had extensive multi-organ involvement. The bilateral occurrence of lesions was a hallmark, being observed in all cases. Ultrasound-guided fine needle aspiration cytology and 131I scintigraphy were pivotal in confirming the diagnosis. Evidence of ‘flip-flop’ between 131I study and fluoro-deoxyglucose positron emission tomography was noted in one patient, while the other three demonstrated concordant lesions in both modalities. At a minimum follow-up period of four years after diagnosis, three patients demonstrated stable disease with radioiodine therapy, and one had expired due to a poorly differentiated lung carcinoma which developed subsequently.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2014 

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References

1Sampson, E, Brierley, JD, Le, LW, Rotstein, L, Tsang, RW. Clinical management and outcome of papillary and follicular (differentiated) thyroid cancer presenting with distant metastasis at diagnosis. Cancer 2007;110:1451–6Google Scholar
2Graham, LD, Roe, SM. Metastatic papillary thyroid carcinoma presenting as a primary renal neoplasm. Am Surg 1995;61:732–4Google Scholar
3Borde, C, Basu, S, Kand, P, Arya, S, Shet, T. Bilateral renal metastases from papillary thyroid carcinoma on post 131I treatment scan: flip-flop sign, radioiodine SPET, 18F-FDG PET, CECT and histopathological correlation. Hell J Nucl Med 2011;14:72–3Google Scholar
4Moudouni, SM, En-Nia, I, Rioux-Leclerq, N, Manunta, A, Guille, F, Lobel, B. Follicular carcinoma of the thyroid metastasis to the kidney nine years after resection of the primary tumour. Ann Urol (Paris) 2002;36:36–7Google Scholar
5Johnson, MW, Morettin, LB, Sarles, HE, Zaharopoulos, P. Follicular carcinoma of the thyroid metastatic to the kidney 37 years after resection of the primary tumour. J Urol 1982;127:114–16CrossRefGoogle Scholar
6Davis, RI, Corson, JM. Renal metastases from well differentiated follicular thyroid carcinoma: a case report with light and electron microscopic findings. Cancer 1979;43:265–8Google Scholar
7Phan, HT, Jager, PL, van der Wal, JE, Sluiter, WJ, Plukker, JT, Dierckx, RA et al. The follow-up of patients with differentiated thyroid cancer and undetectable thyroglobulin (Tg) and Tg antibodies during ablation. Eur J Endocrinol 2008;158:7783CrossRefGoogle ScholarPubMed
8Eustatia-Rutten, CF, Smit, JW, Romijn, JA, van der Kleij-Corssmit, EP, Pereira, AM, Stokkel, MP et al. Diagnostic value of serum thyroglobulin measurements in the follow-up of differentiated thyroid carcinoma, a structured meta-analysis. Clin Endocrinol (Oxf) 2004;6:6174Google Scholar
9Kumar, A, Nadig, M, Patra, V, Srivastava, DN, Verma, K, Bal, CS. Adrenal and renal metastases from follicular thyroid cancer. Br J Radiol 2005;78:1038–41Google Scholar
10Nemec, J, Robling, S, Zamrazil, V, Pohunkova, D. Comparison of the distribution of diagnostic and thyroablative 1-131 in the evaluation of differentiated thyroid cancers. J Nucl Med 1979;20:92–7Google Scholar
11Spies, WG, Wojtowicz, CH, Spies, SM, Shah, AY, Zimmer, AM. Value of post-therapy whole-body I-131 imaging in the evaluation of patients with thyroid carcinoma having undergone high dose I-131 therapy. Clin Nucl Med 1989;14:793800Google Scholar
12Smallridge, RC, Castro, MR, Morris, JC, Young, PR, Reynolds, JC, Merino, MJ et al. Renal metastases from thyroid papillary carcinoma: study of sodium iodide symporter expression. Thyroid 2001;11:795804CrossRefGoogle ScholarPubMed