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Zhang X, Gu X, Li JG, Hu XJ. Metastasis of esophageal squamous cell carcinoma to the thyroid gland with widespread nodal involvement: A case report. World J Clin Cases 2020; 8:4588-4594. [PMID: 33083422 PMCID: PMC7559652 DOI: 10.12998/wjcc.v8.i19.4588] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 08/18/2020] [Accepted: 09/09/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Esophageal cancer is one of the most common causes of cancer-related death. Some patients with esophageal cancer have distant metastases at the time of diagnosis, but metastasis to the thyroid gland (MTG) and multifocal thyroid lesions alone are extremely rare.
CASE SUMMARY In this case report, we present a case of a 69-year-old male with esophageal MTG. The patient visited our hospital for a routine body check-up, which revealed multifocal nodules in his thyroid lobes and enlarged cervical lymph nodes. A fine needle aspiration biopsy showed malignancies in both thyroid lesions and lymph nodes. The patient was initially diagnosed with primary bilateral thyroid cancer that spread to his lymph nodes, and a total thyroidectomy was performed. The histology showed MTG and therefore, a diagnostic work-up was implemented to determine the primary tumor. A fluorine-18-deoxyglucose positron emission tomography scan showed that the lower part of the esophagus and the lymph nodes in the neck, chest, and abdomen were involved. An esophagogastroscopy and corresponding pathology revealed distal esophageal squamous cell carcinoma. The esophageal MTG diagnosis was confirmed with pathological immunohistochemistry.
CONCLUSION This case report highlights the difficulty in diagnosing esophageal MTG. Patients may have no malignancy history and be asymptomatic. Further diagnostic procedures are necessary after MTG is confirmed by cytology or histology, and the final diagnosis should be made according to the identification of the primary malignancy combined with pathological immunohistochemistry findings.
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Affiliation(s)
- Xing Zhang
- Department of Thyroid and Breast Surgery, The Affiliated People's Hospital of Ningbo University, Ningbo 315040, Zhejiang Province, China
| | - Xin Gu
- Department of Pathology, The Affiliated People’s Hospital of Ningbo University, Ningbo 315040, Zhejiang Province, China
| | - Jia-Gen Li
- Department of Thyroid and Breast Surgery, The Affiliated People’s Hospital of Ningbo University, Ningbo 315040, Zhejiang Province, China
| | - Xian-Jie Hu
- Department of Thyroid and Breast Surgery, The Affiliated People’s Hospital of Ningbo University, Ningbo 315040, Zhejiang Province, China
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Panda SK, Satyanarayan B, Prasad SK, Koshy B. Persistent cough: An unexpected diagnosis. J Family Med Prim Care 2020; 9:2548-2551. [PMID: 32754543 PMCID: PMC7380793 DOI: 10.4103/jfmpc.jfmpc_41_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 03/12/2020] [Accepted: 04/07/2020] [Indexed: 11/04/2022] Open
Abstract
Esophageal cancer is the eighth most common cancer and the sixth most common cause of cancer death globally. Esophageal squamous cell carcinoma (ESCC) accounts for 70%-90% of esophageal cancers worldwide, 5% are adenocarcinoma, and 5% represent rare malignancies and metastases from other organs. We present a case where a 54-year-old lady, with multiple readmissions for persistent dry cough and respiratory symptoms, turns out to be an esophageal malignancy. CECT thorax revealed an enhancing wall thickening of the esophagus with paraoesophageal fat stranding, mediastinal lymphadenopathy, and subsegmental right lobe atelectasis, suggestive of a probable esophageal malignancy. An upper gastrointestinal endoscopy showed a circumferential esophageal growth which on biopsy and histopathological examination turned out to be a moderately differentiated squamous cell carcinoma of esophagus.
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Affiliation(s)
- Suman K Panda
- Department of Medicine, Tata Main Hospital, Jamshedpur, Jharkhand, India
| | | | - Satish K Prasad
- Department of Medicine, Tata Main Hospital, Jamshedpur, Jharkhand, India
| | - Binu Koshy
- Department of Medicine, Tata Main Hospital, Jamshedpur, Jharkhand, India
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Rodrigo-Gómez L, Pardal-Refoyo JL, Batuecas-Caletrío Á. Prevalencia de tumores metastásicos en la glándula tiroides. Revisión sistemática y metanálisis. REVISTA ORL 2020. [DOI: 10.14201/orl.23207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Introducción y objetivo: Los tumores metastásicos en la glándula tiroides complican el diagnóstico, el tratamiento y el pronóstico del paciente. El objetivo es conocer la prevalencia de las metástasis en la glándula tiroides referida en la literatura médica y los tumores primarios que con más frecuencia metastatizan en la glándula tiroides. Método: Se realizó una revisión bibliográfica sistemática en las bases de datos de PubMed, La Biblioteca Cochrane y Scopus. Los artículos seleccionados se dividieron en dos grupos, series clínicas de pacientes en los que se hallaron metástasis en tiroides (grupo A) y series de hallazgos de metástasis en tiroides en autopsias (grupo B). Se realizó metanálisis de prevalencia para cada grupo de artículos siguiendo el modelo de efectos aleatorios. Resultados: La prevalencia en cada grupo con su índice de confianza al 95% fue 0.00479 (0.002-0.007) para el grupo A y 0.0362 (0.014-0.059) para el grupo B. La prevalencia de metástasis halladas en autopsias fue 7,58 veces mayor que en los estudios clínicos. En el grupo A la edad media fue 60.82 y en el grupo B 57.20. En ambos grupos las metástasis halladas en tiroides fueron más frecuentes en el sexo femenino. La localización del tumor primario fue diferente en ambos grupos, en el grupo A fue el cáncer de riñón y en el grupo B el cáncer de mama. La variabilidad de la prevalencia de metástasis en tiroides en los diferentes artículos de ambos grupos hace que este estudio tuviese una alta heterogeneidad (índice I2 y Q). Los funnel plot de ambos grupos indicaron alto sesgo de publicación. Discusión: La diferente prevalencia entre series clínicas y autopsias puede implicar que la detección de metástasis en tiroides en la clínica está infradiagnosticada. La razón de esto podría ser que las metástasis intratiroideas se presentan de forma asintomática siendo diagnosticadas como hallazgo casual en autopsias. En otras ocasiones se presentan como un nódulo tiroideo años después del tumor primario, lo que condiciona el diagnóstico. Conclusiones: La prevalencia de metástasis en tiroides es superior en las series de autopsias que en series clínicas (hasta 6.67 veces más frecuente en nuestro estudio). Las metástasis intratiroideas probablemente están infradiagnosticadas por cursar sin clínica siendo diagnosticadas como hallazgo casual en autopsias. Los tumores primarios más frecuentes fueron el riñón (series clínicas) y la mama (series de autopsias).
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Yumoto S, Baba Y, Nomoto D, Oozono K, Eto K, Hiyoshi Y, Nagai Y, Iwatsuki M, Iwagami S, Miyamoto Y, Yoshida N, Mikami Y, Baba H. Thyroid metastasis from esophageal adenocarcinoma: a case report and literature review. Surg Case Rep 2019; 5:137. [PMID: 31471832 PMCID: PMC6717222 DOI: 10.1186/s40792-019-0695-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 08/22/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The incidence of metastatic spread of gastrointestinal malignancies to the thyroid gland is relatively low and most of these malignancies originate from the colorectum. Thyroid metastasis originating from the esophagus is poorly documented. CASE PRESENTATION A 79-year-old man presented with hoarseness of voice and swallowing difficulty. Eighteen months earlier, he had undergone preoperative chemotherapy (S-1 and oxaliplatin [SOX] therapy) and subtotal esophagectomy with regional lymph nodes dissection and retrosternal narrow gastric tube reconstruction for advanced Barrett's esophageal adenocarcinoma. In the ultrasonographic examination, there was a hypoechoic, indistinct border and heterogeneous nodule in the left lobe of the thyroid gland. Pathological examination of an ultrasound-guided fine-needle aspiration showed adenocarcinoma, supporting a diagnosis of esophageal adenocarcinoma metastases in the thyroid. CONCLUSION This is a first case of a patient with thyroid metastasis from Barrett's esophageal adenocarcinoma after subtotal esophagectomy.
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Affiliation(s)
- Shinsei Yumoto
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Yoshifumi Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Daichi Nomoto
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Kazutaka Oozono
- Department of Diagnostic Pathology, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Kojiro Eto
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Yukiharu Hiyoshi
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Yohei Nagai
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Masaaki Iwatsuki
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Shiro Iwagami
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Yuji Miyamoto
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Naoya Yoshida
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Yoshiki Mikami
- Department of Diagnostic Pathology, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Hideo Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
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Ching D, de Boer B, Kumarasinghe MP. HPV positive oesophageal squamous cell carcinoma presenting as a metastasis to the thyroid masquerading as a primary malignancy, diagnosed by cytology. Pathology 2018; 50:682-684. [PMID: 30143344 DOI: 10.1016/j.pathol.2018.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 03/18/2018] [Accepted: 03/27/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Daniel Ching
- Department of Anatomical Pathology, PathWest QEII Medical Centre, Perth, WA, Australia.
| | - Bastiaan de Boer
- Department of Anatomical Pathology, PathWest QEII Medical Centre, Perth, WA, Australia; Department of Anatomical Pathology, Fiona Stanley Hospital, Perth, WA, Australia
| | - M Priyanthi Kumarasinghe
- Department of Anatomical Pathology, PathWest QEII Medical Centre, Perth, WA, Australia; School of Pathology and Laboratory Medicine, UWA, Perth, WA, Australia
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Reese J, Chebolu A, Shen Y, Mihlon F. Case report: Diffuse metastatic infiltration of the thyroid by esophageal adenocarcinoma mimicking non-neoplastic thyroid disease. Radiol Case Rep 2018; 13:108-111. [PMID: 29487644 PMCID: PMC5826462 DOI: 10.1016/j.radcr.2017.10.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 10/20/2017] [Accepted: 10/30/2017] [Indexed: 02/06/2023] Open
Abstract
We report a patient who suffered from esophageal cancer that metastasized to the thyroid. There are only a handful of cases of esophageal cancer with metastases to the thyroid reported in the literature. To our knowledge, this is the first with a diffusely infiltrative pattern (the others were focal masses/nodules). This diffusely infiltrative pattern of metastatic disease is important for radiologists to be aware of because it is particularly difficult to detect and is not characteristically neoplastic by pattern. A diffuse parenchymal abnormality that is bilaterally symmetric is more commonly associated with non-neoplastic diffuse thyroid disease, such as autoimmune thyroid diseases (eg, Graves' disease). As such, in addition to the more common non-neoplastic differential diagnoses associated with diffuse thyroid disease, a diffuse thyroid parenchymal abnormality in a patient with a history of esophageal carcinoma should raise the question of diffuse metastatic infiltration.
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Affiliation(s)
- James Reese
- Department of Radiology, Eastern Virginia Medical School, P.O. Box 1980, Norfolk, VA, 23501, USA
| | - Apoorv Chebolu
- Department of Radiology, Eastern Virginia Medical School, P.O. Box 1980, Norfolk, VA, 23501, USA
| | - YouJun Shen
- Hampton Roads Radiology Associates, Norfolk, VA, USA
| | - Frank Mihlon
- Virginia Beach General Department of Pathology, Norfolk, VA, USA.,Hampton Roads Radiology Associates, Norfolk, VA, USA
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Gigliotti CL, Ferrara B, Occhipinti S, Boggio E, Barrera G, Pizzimenti S, Giovarelli M, Fantozzi R, Chiocchetti A, Argenziano M, Clemente N, Trotta F, Marchiò C, Annaratone L, Boldorini R, Dianzani U, Cavalli R, Dianzani C. Enhanced cytotoxic effect of camptothecin nanosponges in anaplastic thyroid cancer cells in vitro and in vivo on orthotopic xenograft tumors. Drug Deliv 2017; 24:670-680. [PMID: 28368209 PMCID: PMC8241155 DOI: 10.1080/10717544.2017.1303856] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 03/02/2017] [Accepted: 03/05/2017] [Indexed: 12/30/2022] Open
Abstract
Anaplastic carcinoma of the thyroid (ATC) is a lethal human malignant cancer with median survival of 6 months. To date, no treatment has substantially changed its course, which makes urgent need for the development of novel drugs or novel formulations for drug delivery. Nanomedicine has enormous potential to improve the accuracy of cancer therapy by enhancing availability and stability, decreasing effective doses and reducing side effects of drugs. Camptothecin (CPT) is an inhibitor of DNA topoisomerase-I with several anticancer properties but has poor solubility and a high degradation rate. Previously, we reported that CPT encapsulated in β-cyclodextrin-nanosponges (CN-CPT) increased solubility, was protected from degradation and inhibited the growth of prostate tumor cells both in vitro and in vivo. The aim of this study was to extend that work by assessing the CN-CPT effectiveness on ATC both in vitro and in vivo. Results showed that CN-CPT significantly inhibited viability, clonogenic capacity and cell-cycle progression of ATC cell lines showing a faster and enhanced effect compared to free CPT. Moreover, CN-CPT inhibited tumor cell adhesion to vascular endothelial cells, migration, secretion of pro-angiogenic factors (IL-8 and VEGF-α), expression of β-PIX, belonging to the Rho family activators, and phosphorylation of the Erk1/2 MAPK. Finally, CN-CPT significantly inhibited the growth, the metastatization and the vascularization of orthotopic ATC xenografts in SCID/beige mice without apparent toxic effects in vivo. This work extends the previous insight showing that β-cyclodextrin-nanosponges are a promising tool for the treatment of ATC.
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Affiliation(s)
- Casimiro Luca Gigliotti
- Department of Health Sciences, Interdisciplinary Research Center of Autoimmune Diseases, UPO, Novara, Italy
| | - Benedetta Ferrara
- Department of Drug Science and Technology, University of Torino, Torino, Italy
| | - Sergio Occhipinti
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Elena Boggio
- Department of Health Sciences, Interdisciplinary Research Center of Autoimmune Diseases, UPO, Novara, Italy
| | - Giuseppina Barrera
- Department of Clinical and Biological Sciences, University of Torino, Torino, Italy
| | - Stefania Pizzimenti
- Department of Clinical and Biological Sciences, University of Torino, Torino, Italy
| | - Mirella Giovarelli
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Roberto Fantozzi
- Department of Drug Science and Technology, University of Torino, Torino, Italy
| | - Annalisa Chiocchetti
- Department of Health Sciences, Interdisciplinary Research Center of Autoimmune Diseases, UPO, Novara, Italy
| | - Monica Argenziano
- Department of Drug Science and Technology, University of Torino, Torino, Italy
| | - Nausicaa Clemente
- Department of Health Sciences, Interdisciplinary Research Center of Autoimmune Diseases, UPO, Novara, Italy
| | - Francesco Trotta
- Department of Chemistry, University of Torino, Torino, Italy, and
| | - Caterina Marchiò
- Department of Medical Sciences, University of Torino, Torino, Italy
| | - Laura Annaratone
- Department of Medical Sciences, University of Torino, Torino, Italy
| | - Renzo Boldorini
- Department of Health Sciences, Interdisciplinary Research Center of Autoimmune Diseases, UPO, Novara, Italy
| | - Umberto Dianzani
- Department of Health Sciences, Interdisciplinary Research Center of Autoimmune Diseases, UPO, Novara, Italy
| | - Roberta Cavalli
- Department of Drug Science and Technology, University of Torino, Torino, Italy
| | - Chiara Dianzani
- Department of Drug Science and Technology, University of Torino, Torino, Italy
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Esophageal Cancer Metastases to Unexpected Sites: A Systematic Review. Gastroenterol Res Pract 2017; 2017:1657310. [PMID: 28659974 PMCID: PMC5474273 DOI: 10.1155/2017/1657310] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Accepted: 04/24/2017] [Indexed: 12/12/2022] Open
Abstract
The most common pattern of esophageal cancer metastases (ECM) is to the lymph nodes, lung, liver, bones, adrenal glands, and brain. On the other hand, unexpected metastasis (UM) spread to uncommon sites has increasingly reported and consequently affected the pathway of diagnosis, staging, and management. Using the PubMed database, a systematic search of the following headings “Esophageal” and “Metastasis” or “Metastases” was performed, 10049 articles were identified, and the articles were included if they demonstrated unexpected ECM. 84% of cases were men with an average age of 60.7 years. EC was located in the lower third in 65%. Two-thirds of the UM originated from the lower esophagus, and the two major histological types were adenocarcinoma 40% and squamous cell carcinoma 60%. Metastases were disseminated toward five main anatomical sites: the head and neck (42%), thoracic (17%), abdomen and pelvis (25%), extremities (9%), and multiple skin and muscle metastases (7%). The EC metastases were found to be synchronous 42% and metachronous 58%, isolated in 53.5% and multiple in 46.5%. The overall survival rate was 10.2 months. Since distant metastases are responsible for most EC-related deaths, understanding of ECM dissemination patterns needs more extensive studies. These critical data are the cornerstone of optimal cancer approach and treatment.
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Ye-huan L, Shi-xu L, Yi-li Z, Ou-chen W, Xiao-hua Z. Unexpected esophageal diseases appeared in thyroid resections. World J Surg Oncol 2015; 13:131. [PMID: 25888936 PMCID: PMC4387597 DOI: 10.1186/s12957-015-0542-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Accepted: 03/07/2015] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE In order to avoid the misdiagnosis of thyroid diseases, we need to discuss the clinical features and diagnostic methods of cervical esophageal cancer and Zenker's diverticulum. METHODS The clinical and laboratory data of seven cases were reviewed retrospectively, and in all cases, esophageal-related diseases were misdiagnosed as thyroid diseases preoperatively. Among them, two cases were cervical esophageal cancer metastasized to thyroids but initially, they were misdiagnosed as thyroid cancer. The other five cases were Zenker's diverticulum, but were originally diagnosed as nodular goiter, and two out of the five cases were found with calcification. They were all detected by ultrasound examination without any clinical feature of esophageal diseases. Previous literatures only reported five cases of thyroid metastasis and three cases of Zenker's diverticulum. RESULTS In both cases where cervical esophageal cancer metastasized to thyroid, anterior cervical neoplasm biopsy and surgical removal were performed followed by postoperative radiotherapy and chemotherapy. Both patients died from esophageal cancers in 7 and 15 months postoperatively. All five cases of Zenker's diverticulum received excision and repair without any postoperative complication or recurrence in the following 2 to 7 years. CONCLUSIONS Cervical esophageal cancer and Zenker's diverticulum may be misdiagnosed as thyroid disease. Careful and comprehensive diagnostic tests would be required to avoid misdiagnosis.
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Affiliation(s)
- Liu Ye-huan
- Department of Oncology, The First Affiliated Hospital of Wenzhou Medical University, South of Bai-xiang Street, Ou-hai District, 325000, Wenzhou, Zhejiang, People's Republic of China.
| | - Lyu Shi-xu
- Department of Oncology, The First Affiliated Hospital of Wenzhou Medical University, South of Bai-xiang Street, Ou-hai District, 325000, Wenzhou, Zhejiang, People's Republic of China.
| | - Zhou Yi-li
- Department of Oncology, The First Affiliated Hospital of Wenzhou Medical University, South of Bai-xiang Street, Ou-hai District, 325000, Wenzhou, Zhejiang, People's Republic of China.
| | - Wang Ou-chen
- Department of Oncology, The First Affiliated Hospital of Wenzhou Medical University, South of Bai-xiang Street, Ou-hai District, 325000, Wenzhou, Zhejiang, People's Republic of China.
| | - Zhang Xiao-hua
- Department of Oncology, The First Affiliated Hospital of Wenzhou Medical University, South of Bai-xiang Street, Ou-hai District, 325000, Wenzhou, Zhejiang, People's Republic of China.
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