Endocrine Abstracts

Introduction

Differentiated thyroid cancers DTC are metastatic in 10% of cases. The most frequent sites are the lungs, the bones, the brain and the liver. The presence of a metastasis reduces the life expectancy of patients by 60%. The objective of this work is to describe the characteristics of metastatic DTC in our service.

Methodology

Descriptive retrospective study of 740 patient files monitored at the endocrinology department of the CHU IBN ROCHD for DTC from January 1986 to April 2019. All cases of DTC with regional or distant metastases were included. The variables studied: age, histological variant, capsular intrusion, TNM stage and multifocality. Statistical analysis performed by IBM SPSS Statistics 25 software.

Results

75 patients had presented regional or distant metastases, a prevalence of 9.7%. The mean age at diagnosis was 46.4 years ± 14.2 years. The sex ratio M/F: 0.1. All patients had undergone a total thyroidectomy, 49% of them with lymph node dissection. 78% of patients underwent ira therapy with an average delay of 19 months after surgery. Metastasis were revealed in 14 cases. 56 patients had lymph node metastasis, 17 patients had bone metastasis and 13 patients had lung metastasis. The most frequent histological types were classical papillary carcinoma (53%), papillary carcinoma with vesicular differentiation (24%), followed by vesicular carcinoma (11%). Regarding the histological characteristics, capsular effraction was found in 34% of cases, vascular emboli in 16% and multifocality in 23% of cases. Analysis of the variables studied showed that patients aged over 55 had more vascular emboli with no statistically significant difference P = 0.06, capsular effraction was statistically more common in women P = 0.02. The presence of bone metastases was statistically correlated with the presence of vascular emboli P = 0.006.

Conclusion

The regional or long-term recurrence rate of differentiated thyroid cancers in our series is relatively similar to that found in the literature