ECE2017 Eposter Presentations: Thyroid Thyroid (non-cancer) (260 abstracts)
Isolated bone metastases: a rare form of presentation of papillary thyroid carcinoma
Mariana Peyroteo , Cátia Ribeiro , Pedro C Martins , Ana Ferreira , Laurinda Giesteira , Rui Barbosa , Machado Carvalho , António Ramalho , Augusto Moreira & Abreu de Sousa
IPO Porto, Porto, Portugal.
Background: Papillary thyroid cancer (PTC) is the most frequent type of well-differentiated thyroid cancer (WDTC) and frequently poses a management dilemma. Its indolent behavior associated with high long term survival support the trend towards a more conservative management approach. The authors present a case of isolated bone metastases as the form of presentation of papillary thyroid carcinoma. A 61-year-old man was admitted with complaints of lower back pain for the previous 3 months. A lumbosacral spine CT and sacral MRI were performed, showing a 9×9×7,5 cm mass centered on the sacrum infiltrating the sacral canal, with soft tissue density associated with extensive lytic lesions of the sacral vertebra, suggestive of chordoma. The patient was submitted to a sacrectomy with reconstruction. The histology of the removed specimen revealed involvement of the sacrum by thyroid cancer, namely papillary type (follicular variant), with positivity for thyroglobulin and TTF-1 on the immunohistochemistry study. The thyroid ultrasound showed multiple nodes bilaterally and the FDG-PET scan showed increased uptake in the left thyroid lobe and in the area of the sacral surgery, without other areas of high uptake. The patient was submitted to a total thyroidectomy, with the histologic study of the thyroid revealing a multifocal papillary thyroid cancer (follicular and oxyphilic variants). Ablative treatment with radioactive iodine was administered after the surgery.
Conclusion: Distant metastatic disease at presentation is rare in WDTC, with these patients having less favorable outcomes. For this reason, many risk stratification algorithms include metastatic disease as a high risk factor. This clinical case reports a rare form of presentation, showing us that, although most PTC are indolent, there are still factors about this type of tumor we need to study in order to be able to single out these specific cases for more aggressive treatment.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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