Surgical treatment of intrathyroid metastases: preliminary results of a multicentric study.
BACKGROUND
Intrathyroid metastases (ITM) are rare and usually have a dismal prognosis. The aim of this study was to detect which neoplasms metastasize most often to the thyroid gland, their clinical features and treatment options.


METHODS
Retrospective analysis of clinical files of 17,122 patients submitted to surgery for thyroid disease between 1995 and 2005. Twenty-five patients (median age 61 years) were affected by ITM.


RESULTS
The site of the primary tumor was: kidney (15), lung (4), colon (3), breast (1), melanoma (1), and unknown in 1 patient. Ten patients (40%) complained of preoperative symptoms, in the others, thyroid involvement was incidentally discovered during the follow-up for the primary cancer. Twenty patients (80%) underwent total thyroidectomy, 3 received thyroid lobectomy and 2 palliative procedures. Morbidity was 16%, mortality was nil. The median follow-up was 24 months.


CONCLUSIONS
ITM should always be suspected in any patient with a previous history of malignancy. Fine-needle agobiopsy (FNAB) with immunohistochemical stains may help in preoperative workup. A long delay between the primary tumor and the recurrence warrants surgery and total thyroidectomy seems to be the treatment of choice because of the multifocality of metastasis to the thyroid gland.
Calzolari
Filippo
F
Inter-Hospital Functional Area of Endocrine Surgery, Umbria Region, Perugia, Italy. calzolari@chirurgia.it
Sartori
Paola Vincenza
PV
Talarico
Carlo
C
Parmeggiani
Domenico
D
Beretta
Edoardo
E
Pezzullo
Luciano
L
Bovo
Giorgio
G
Sperlongano
Pasquale
P
Monacelli
Massimo
M
Lucchini
Roberta
R
Misso
Claudia
C
Gurrado
Angela
A
D'Ajello
Michele
M
Uggeri
Franco
F
Puxeddu
Efisio
E
Nasi
Piergiorgio
P
Testini
Mario
M
Rosato
Lodovico
L
Barbarisio
Alfonso
A
Avenia
Nicola
N
D000230:Adenocarcinoma / Q000473:pathology / Q000556:secondary / Q000601:surgery; D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D001943:Breast Neoplasms / Q000473:pathology; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000556:secondary / Q000601:surgery; D003110:Colonic Neoplasms / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology; D008175:Lung Neoplasms / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery*