title: Surgical treatment of intrathyroid metastases: preliminary results of a multicentric study.
abstract: 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.
authors.affiliation: Inter-Hospital Functional Area of Endocrine Surgery, Umbria Region, Perugia, Italy. calzolari@chirurgia.it
authors.forename: Filippo
authors.initials: F
authors.lastname: Calzolari
authors.forename: Paola Vincenza
authors.initials: PV
authors.lastname: Sartori
authors.forename: Carlo
authors.initials: C
authors.lastname: Talarico
authors.forename: Domenico
authors.initials: D
authors.lastname: Parmeggiani
authors.forename: Edoardo
authors.initials: E
authors.lastname: Beretta
authors.forename: Luciano
authors.initials: L
authors.lastname: Pezzullo
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bovo
authors.forename: Pasquale
authors.initials: P
authors.lastname: Sperlongano
authors.forename: Massimo
authors.initials: M
authors.lastname: Monacelli
authors.forename: Roberta
authors.initials: R
authors.lastname: Lucchini
authors.forename: Claudia
authors.initials: C
authors.lastname: Misso
authors.forename: Angela
authors.initials: A
authors.lastname: Gurrado
authors.forename: Michele
authors.initials: M
authors.lastname: D'Ajello
authors.forename: Franco
authors.initials: F
authors.lastname: Uggeri
authors.forename: Efisio
authors.initials: E
authors.lastname: Puxeddu
authors.forename: Piergiorgio
authors.initials: P
authors.lastname: Nasi
authors.forename: Mario
authors.initials: M
authors.lastname: Testini
authors.forename: Lodovico
authors.initials: L
authors.lastname: Rosato
authors.forename: Alfonso
authors.initials: A
authors.lastname: Barbarisio
authors.forename: Nicola
authors.initials: N
authors.lastname: Avenia
mesh_terms: 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*