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Pancreatic metastasis of papillary thyroid carcinoma preoperatively diagnosed by endoscopic ultrasound-guided fine-needle aspiration biopsy: a case report with review of literatures

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Abstract

Pancreatic metastatic tumors from thyroid carcinoma are extremely rare. We report a case of an 80-year-old female with a pancreatic metastatic tumor derived from papillary thyroid carcinoma which was initially resected 158 months prior to detection of the metastatic pancreatic tumor. The patient has encountered cervical lymph-node metastasis on three occasions following the initial operation. Metastatic pancreatic lesions and cervical lymph nodes were first detected using 18-fluorodeoxyglucose positron-emission tomography/computed tomography, and she was preoperatively diagnosed using endoscopic ultrasound-guided fine-needle aspiration biopsy. A coin lesion, 10 mm in size, was detected in the left lung by chest computed tomography with no abnormal uptake in 18-fluorodeoxyglucose positron-emission tomography/computed tomography. Distal pancreatectomy and cervical lymph-node dissection were performed. Adjuvant chemotherapy with weekly paclitaxel was administered because anaplastic transformation had been detected in one of the cervical lymph nodes. The patient eventually died from multiple lung metastases 11 months after removing the metastatic pancreatic lesion. We reported a rare case of a pancreatic metastatic tumor from thyroid carcinoma, and found that 18-fluorodeoxyglucose positron-emission tomography/computed tomography and endoscopic ultrasound-guided fine-needle aspiration biopsy are useful for preoperatively diagnosing tumors.

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References

  1. Sperti C, Pasquali C, Liessi G, et al. Pancreatic resection for metastatic tumors to the pancreas. J Surg Oncol. 2003;83:161–6.

    Article  Google Scholar 

  2. Reddy S, Wolfgang CL. The role of surgery in the management of isolated metastases to the pancreas. Lancet Oncol. 2009;10:287–93.

    Article  Google Scholar 

  3. Ito Y, Miyauchi A. Prognostic factors and therapeutic strategies for differentiated carcinomas of the thyroid. Endocr J. 2009;56:177–92.

    Article  Google Scholar 

  4. Sperti C, Moletta L, Patanè G. Metastatic tumors to the pancreas: the role of surgery. World J Gastrointest Oncol. 2014;6:381–92.

    Article  Google Scholar 

  5. Brierly JD. Thyroid gland. In: Brierley JD, Gospodarowicz MK, Wittekind C, editors. TNM classification of malignant tumours. 8th ed. Oxford: Wiley; 2017. pp. 51–4.

    Google Scholar 

  6. Sherman SI. Thyroid carcinoma. Lancet. 2003;361:501–11.

    Article  Google Scholar 

  7. Braverman LE, Cooper DS. Staging and prognosis of differentiated thyroid cancer. Werner and Ingbar’s the thyroid. A fundamental and clinical text. 10th ed. Philadelphia: Lippincott Williams and Wilkins; 2012.

    Google Scholar 

  8. Nakamura E, Shimizu M, Itoh T, et al. Secondary tumors of the pancreas: clinicopathological study of 103 autopsy cases of Japanese patients. Pathol Int. 2001;51:686–90.

    Article  CAS  Google Scholar 

  9. Sugimura H, Tamura S, Kodama T, et al. Metastatic pancreatic cancer from the thyroid; clinical imaging mimicking non functioning islet cell tumor. Radiat Med. 1991;9:167–9.

    CAS  PubMed  Google Scholar 

  10. Angeles-Angeles A, Chable-Montero F, Martinez-Benitez B, et al. Unusual metastases of papillary thyroid carcinoma: report of 2 cases. Ann Diagn Pathol. 2009;13:189–96.

    Article  Google Scholar 

  11. Jobran R, Baloch ZW, Aviles V, et al. Tall cell papillary carcinoma of the thyroid: metastatic to the pancreas. Thyroid. 2000;10:185–7.

    Article  CAS  Google Scholar 

  12. Hyodo M, Nagai H, Sata N, et al. Long-term survivor without recurrence after resection of simultaneous solitary pancreatic metastasis from thyroid medullary carcinoma. Hepatogastroenterology. 2003;50:1687–8.

    PubMed  Google Scholar 

  13. Siddiqui AA, Olansky L, Sawh RN, et al. Pancreatic metastasis of tall cell variant of papillary thyroid carcinoma: diagnosis by endoscopic ultrasound-guided fine needle aspiration. JOP. 2006;7:417–22.

    PubMed  Google Scholar 

  14. Borschitz T, Eichhorn W, Fottner C, et al. Diagnosis and treatment of pancreatic metastases of papillary thyroid carcinoma. Thyroid. 2010;20:93–8.

    Article  Google Scholar 

  15. Chen L, Brainard JA. Pancreatic metastasis from papillary thyroid carcinoma diagnosed by endoscopic ultrasound-guided fine needle aspiration: a case report. Acta Cytol. 2010;54:640–4.

    Article  Google Scholar 

  16. Layfield LJ, Hirschowitz SL, Adler DG. Metastatic disease to the pancreas documented by endoscopic ultrasound guided fine-needle aspiration: a seven-year experience. Diagn Cytopathol. 2012;40:228–33.

    Article  Google Scholar 

  17. Alzahrani AS, AlQaraawi A, Al Sohaibani F, et al. Pancreatic metastasis arising from a BRAF(V600E)-positive thyroid cancer: the role of endoscopic ultrasound-guided biopsy and response to sorafenib therapy. Thyroid. 2012;22:536–41.

    Article  CAS  Google Scholar 

  18. Tunio MA, Alasiri M, Riaz K, et al. Pancreas as delayed site of metastasis from papillary thyroid carcinoma. Case Rep Gastrointest Med. 2013;2013:386263.

    PubMed  PubMed Central  Google Scholar 

  19. Niess H, Conrad C, Kleespies A, et al. Surgery for metastasis to the pancreas: is it safe and effective? J Surg Oncol. 2013;107:859–64.

    Article  Google Scholar 

  20. Na HJ, Kim BH, Kim JR, et al. FDG PET/CT in the detection of pancreatic metastasis in a patient with follicular thyroid carcinoma and negative I-131 whole body scan findings. Intern Med. 2014;53:2095–9.

    Article  Google Scholar 

  21. Li XO, Li ZP, Wang P, et al. Pancreatic metastasis of papillary thyroid carcinoma: a case report with review of the literature. Int J Clin Exp Pathol. 2014;7:819–22.

    PubMed  PubMed Central  Google Scholar 

  22. Hoshimoto S, Aiura K, Ueda M, et al. Resection of pancreatic metastases originating from papillary carcinoma of the thyroid. A case report. J Jpn Panc Soc. 2004;19:410–5.

    Google Scholar 

  23. Miyamoto T, Sasaki Y, Furunaga T, et al. Metastatic pancreatic tumor from papillary thyroid carcinoma: a case report and literature review. Jpn J of Gastroenterol Surg. 2011;44:442–8.

    Article  Google Scholar 

  24. Kimura M, Yamada T, Kato Y, et al. A case of metastatic pancreas tumor from papillary carcinoma of thyroid treated by hand-assisted laparoscope surgery (HALS) distal pancreatectomy with splenectomy. Jpn J of Gastroenterol Surg. 2012;45:203–9.

    Article  Google Scholar 

  25. Urakami A, Hirabayashi Y, Matsumoto H, et al. A case of multiple pancreatic metastases from thyroid papillary carcinoma treated by total pancreatectomy. Kawasaki Med J. 2012;38:211–7.

    Google Scholar 

  26. Sato T, Isotani E, Nakagawa T, et al. A case of pancreatic metastasis from a papillary thyroid carcinoma. J Abdom Emerg Med. 2013;33:1275–9.

    Google Scholar 

  27. Ohtawa T, Aoyama T, Yoshikawa K, et al. Pancreatic metastasis of papillary carcinoma of the thyroid—report of a resected case. J Biliary Tract Pancreas. 1997;18:199–203.

    Google Scholar 

  28. Naritomi M, Hatake S, Kobayasi H, et al. A case of pancreatic metastasis from papillary thyroid carcinoma diagnosed by pancreatic duct lavage cytology. Okayama Bull Jpn Soc Clin Cytol. 2011;30:37–9.

    Google Scholar 

  29. Kano S, Kiriyama M, Hagino S, et al. A case of resected pancreatic metastasis from a papillary thyroid carcinoma. Rinsho Geka (J Clin Surg). 2015;70:1403–8.

    Google Scholar 

  30. Ichikawa K, Kono M, Kondo A, et al. Resection of a pancreatic metastasis from follicular thyroid carcinoma. Rinsho Geka (J Clin Surg). 2015;70:1530–4.

    Google Scholar 

  31. Davidson M, Olsen RJ, Ewton AA, et al. Pancreas metastases from papillary thyroid carcinoma: a review of the literature. Endocr Pract. 2017;23:1425–9.

    Article  Google Scholar 

  32. Ferrozzi F, Bova D, Campodonico F, et al. Pancreatic metastases: CT assessment. Eur Radiol. 1997;7:241–5.

    Article  CAS  Google Scholar 

  33. Klein KA, Stephens DH, Welch TJ. CT characteristics of metastatic disease of the pancreas. Radiographics. 1998;18:369–78.

    Article  CAS  Google Scholar 

  34. Ramos-Vara JA, Miller MA, Johnson GC, et al. Immunohistochemical detection of thyroid transcription factor-1, thyroglobulin, and calcitonin in canine normal, hyperplastic, and neoplastic thyroid gland. Vet Pathol. 2002;39:480–7.

    Article  CAS  Google Scholar 

  35. Katoh R, Kawaoi A, Miyagi E, et al. Thyroid transcription factor-1 in normal, hyperplastic and neoplastic follicular thyroid cells examined by immunohistochemistry and nonradioactive in situ hybridization. Mod Pathol. 2000;13:570–6.

    Article  CAS  Google Scholar 

  36. Tang KT, Lee CH. BRAF mutation in papillary thyroid carcinoma: pathogenic role and clinical implications. J Chin Med Assoc. 2010;73:113–28.

    Article  CAS  Google Scholar 

  37. Ciampi R, Nikiforov YE. RET/PTC rearrangements and BRAF mutations in thyroid tumorigenesis. Endocrinology. 2007;148:936–41.

    Article  CAS  Google Scholar 

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Correspondence to Tatsuo Shimura.

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Yuko Murakami, Tatsuo Shimura, Ryo Okada, Yasuhide Kofunato, Teruhide Ishigame, Rei Yashima, Keiichi Nakano, Shinichi Suzuki, and Seiichi Takenoshita declare that they have no conflict of interest.

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All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Murakami, Y., Shimura, T., Okada, R. et al. Pancreatic metastasis of papillary thyroid carcinoma preoperatively diagnosed by endoscopic ultrasound-guided fine-needle aspiration biopsy: a case report with review of literatures. Clin J Gastroenterol 11, 521–529 (2018). https://doi.org/10.1007/s12328-018-0875-z

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  • DOI: https://doi.org/10.1007/s12328-018-0875-z

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