Secondary malignancy of the thyroid gland and its management.
BACKGROUND
Secondary cancer of the thyroid gland is widely acknowledged as infrequent but is a persistent problem requiring ongoing awareness, particularly with respect to clinical recognition and treatment.


METHODS
From 1978 to 1993, a 15-year period, patients demonstrating secondary involvement of the thyroid gland as a surgical problem were collected and analyzed with regard to pathology, demography, behavior of primary and secondary disease, treatment, and patient outcome.


RESULTS
In the 15-year span, 11 patients with secondary involvement of the thyroid gland were recognized, consisting of 3 men and 8 women with primary lesions occurring in oral cavity, esophagus, stomach, colon, pancreas, breast, skin, unknown, kidney, and lung. Needle biopsy produced a 90% malignancy rate but in only half of such cases was the diagnosis specific for secondary malignancy. Eight of 11 underwent palliative surgery, usually total thyroidectomy. No patient survived > 2 years. There was no undue surgical morbidity. One patient died of pulmonary embolus postoperatively.


CONCLUSIONS
Secondary cancer of the thyroid is rare and can be detected by fine-needle aspiration biopsy in the face of clinical findings. Where indicated, palliative thyroidectomy can be effective, because other methods of treatment appear ineffective.
Rosen
I B
IB
Department of Surgery, University of Toronto, Mount Sinai Hospital, Ontario, Canada.
Walfish
P G
PG
Bain
J
J
Bedard
Y C
YC
D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D015996:Survival Rate; D013964:Thyroid Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D013965:Thyroidectomy; D016896:Treatment Outcome