title: Diagnosis and treatment of pancreatic metastases of a papillary thyroid carcinoma.
abstract: BACKGROUND
  Apart from regional lymph node metastases, systemic metastases occur sporadically in papillary thyroid carcinomas (PTC). The lung and bones are the most frequent localizations. Additionally known but extremely rare locations are metastases of the skeletal muscles, ovaries, submandibular gland, sphenoidal sinus, brain, adrenals, and, as shown in only two previously published cases to date, the pancreas.
  
  
  CONCLUSIONS
  In this article we report about two additional patients with pancreatic metastases from PTC. There is almost no prior experience about therapeutic approaches to this type of metastases. In both patients distant metastases within the pancreas were successfully removed. Postoperative histology confirmed the diagnoses. Supplemental genetic analysis did not demonstrate a BRAF V600E mutation or expression of a RET/PTC1 rearrangement in one case, but revealed a BRAF V600E mutation in the second case. Surgery avoided impending complications maintaining quality of life. One patient had a tumor-specific survival of 42 months. The other patient has occult disease.
  
  
  CONCLUSIONS
  Our two patients benefited of a calculated aggressive surgical action. Thus, if low perioperative mortality and morbidity can be warranted, surgical measures are justifiable in selected cases.
authors.affiliation: Endocrine Surgery, Clinic of General and Abdominal Surgery, University Medical Center, Gutenberg University Mainz, Mainz, Germany. borschit@mail.uni-mainz.de
authors.forename: Thomas
authors.initials: T
authors.lastname: Borschitz
authors.forename: Waltraud
authors.initials: W
authors.lastname: Eichhorn
authors.forename: Christian
authors.initials: C
authors.lastname: Fottner
authors.forename: Torsten
authors.initials: T
authors.lastname: Hansen
authors.forename: Arno
authors.initials: A
authors.lastname: Schad
authors.forename: Simin
authors.initials: S
authors.lastname: Schadmand-Fischer
authors.forename: Matthias M
authors.initials: MM
authors.lastname: Weber
authors.forename: Mathias
authors.initials: M
authors.lastname: Schreckenberger
authors.forename: Hauke
authors.initials: H
authors.lastname: Lang
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Musholt
mesh_terms: D000328:Adult; D002291:Carcinoma, Papillary / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery; D003287:Contrast Media; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D009154:Mutation; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery; D049268:Positron-Emission Tomography; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics; D018714:Radiotherapy, Adjuvant; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D013965:Thyroidectomy; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D019788:Fluorodeoxyglucose F18; C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf