Sarcoma and thyroid disorders: a common etiology?
We have recently observed that many of our sarcoma patients presented also with thyroid disorders. Literature data are almost unavailable on this topic. The relationship between the sarcoma and thyroid disorders is examined. Retrospective analysis of files of patients with sarcoma and clinically overt thyroid disorders was carried out. Of the 375 patients with soft tissue sarcomas (STS) and 235 with bone sarcoma (BS) including small blue round cell tumors (SBRC), 28 patients (4.6%) had an associated significant thyroid disorder. The types of sarcoma were mainly liposarcoma followed by malignant fibrous histiocytoma, leiomyosarcoma and bone sarcoma. The primary sites were mainly limb and trunk. The interval between the diagnosis of the thyroid disorder and the sarcoma varied between -14 years (thyroid first) and +16.5 years (thyroid later) with a median of -0.2 years. Thyroid disorders included goiter, thyroiditis and carcinoma. There are both basic-science and clinical evidence to a possible common pathway that leads to the association between overt thyroid disorders and sarcomas of bone or soft tissues. Oncogene erbA activity is related to thyroid receptors to T3 and to development of sarcoma. Cross talk of the sarcoma oncogene and the erbA might contribute to the development of sarcoma. The thyroid hormone receptor and the highly related viral oncoprotein v-erbA are found exclusively in the nucleus as stable constituents of chromatin. It has been shown that v-erbA can block the spontaneous differentiation in erythroid cells transformed by various retroviral oncogenes. V-erbA can alter the spectrum of neoplasia induced by the v-src oncogene, which causes predominantly sarcomas and erythroblastosis in chicks. The erbA can cooperate with other oncogenes such as v-erbB or with v-fms, v-ras, and c-kit. Cooperation with v-myc may play a role in the development of rhabdomyosarcoma especially in thyroid hormone deficiency state. The possible clinical implications are the need to screen patients with sarcoma to thyroid disorders, and patients with thyroid disorders for malignant diseases.
Merimsky
Ofer
O
Department of Oncology, The Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 64239, Israel. merimsky@zahav.net.il
Issakov
Josephine
J
Kollender
Yehuda
Y
Inbar
Moshe
M
Bickels
Jacob
J
Meller
Isaac
I
D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000150:complications* / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018774:Oncogene Proteins v-erbA / Q000378:metabolism; D020239:Receptor Cross-Talk / Q000502:physiology; D011988:Receptors, Thyroid Hormone / Q000378:metabolism; D012509:Sarcoma / Q000150:complications* / Q000209:etiology* / Q000378:metabolism; D015398:Signal Transduction; D013959:Thyroid Diseases / Q000150:complications* / Q000378:metabolism
D018774:Oncogene Proteins v-erbA; D011988:Receptors, Thyroid Hormone