ECE2019 Poster Presentations Thyroid 1 (70 abstracts)
Jejunum metastasis and perforation from anaplastic thyroid cancer
Stavroula Gavriilidou 1 , Constantinos Belis 1 , Aikaterini Afentoulidi 1 , Kalliopi Xydiari 1 , Maria Fotou 2 , Vassiliki Oikonomou 2 , Christina Zoumpouli 3 , Evangelia Stroumpouli 4 , Vasileios Athanasiou 1 , Sofia Malaktari-Skarantavou 1 & Christos Savvidis 1
1Department of Endocrinology and Metabolism, Hippocratio General Hospital of Athens, Athens, Greece; 2Department of Cytology, Hippocratio General Hospital of Athens, Athens, Greece; 3Department of Histopathology, Hippocratio General Hospital of Athens, Athens, Greece; 4Radiology Department, Hippocratio General Hospital of Athens, Athens, Greece.
Introduction: Anaplastic thyroid carcinoma (ATC) accounts for 1.7% of all thyroid cancers with poor prognosis and a median survival of 4 to 12 months. We report a case of ATC with small intestine perforation due to metastasis in the jejunum.
Case report: A 57-year-old woman was referred to our department for a rapidly enlarging goiter and dyspnea. Her latest thyroid ultrasound was performed about a month ago and demonstrated 2 nodules measuring 21×16 mm and 10 mm respectively, with calcifications present. The fine-needle aspiration revealed Bethesda III cytology. A new cytologic test was performed to a 4,5 cm nodule and showed neoplastic cells with characteristics of poorly differentiated thyroid cancer. The CT scans revealed a soft tissue mass with calcifications, extending from the thyroid gland to the upper half of the mediastinum and distant metastases to lung, brain and intestine. The patient underwent a partial thyroidectomy and tracheotomy to relieve her respiratory distress and the histological report showed anaplastic thyroid cancer. Brain CT that was performed due to altered levels of consciousness revealed metastatic sites in the semioval center. A few days later the patient presented an acute abdominal symptomatology and a CT scan revealed enlarged periportal lymph nodes, a regional increase in mesenteric fat density, small amounts of free intraabdominal fluid, small air bubbles in the abdomen and thickening of a small bowel fold and peritoneal fluid in the pouch of Douglas. The patient underwent surgery and histology revealed 6 metastatic foci of 2-15 mm in diameter dispersed within an 8 cm in lenth jejunal wall. One of these foci caused a 12 mm long perforation of the intestine. The patient, despite the supportive treatment, died on the 26th day of hospitalization.
Conclusion: All ATCs are considered as TNM stage IV. The 1-year survival rate is 20%. About 10-50% of all patients will have extensive disease at diagnosis. Most common metastases involve lung and pleura. Brain metastases account for 1-5% and are associated with a poor prognosis, while the jejunum metastases are extremely rare (< 2%).
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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