title: Unusual metastases from tall cell variant of papillary thyroid cancer.
abstract: BACKGROUND
  Tall cell variant (TCV) cancer is considered more aggressive than the classic variant of papillary thyroid cancer (PTC). Distant metastases are more common among this variant and affect survival. Little is known about the molecular pattern of this histotype.
  
  
  METHODS
  This is a report of 2 cases of unusual metastases from TCV, BRAF V600E-positive.
  
  
  RESULTS
  A 38-year-old woman developed subcutaneous metastases during short-term follow-up; at medium-term follow-up, the patient showed detectable stimulated serum thyroglobulin without disease evidence at imaging. A 33-year-old man presented incidental thymic metastases at time of surgical treatment; this is the first case of not ectopic thymic metastases from PTC.
  
  
  CONCLUSIONS
  TCV may present with unusual metastases already during early follow-up. The more aggressive behavior could be linked to the higher prevalence of BRAF point mutations, but only a long-term follow-up might clarify if this association could worsen the prognosis. Moreover, skin metastases have been predictive factors of worse outcome in our patients, but not thymic metastases.
authors.affiliation: Endocrinology, Department of Translational Medicine, University "A. Avogadro,", Novara, Italy; Department of Diabetology, AOU "Maggiore della Carità,", Novara, Italy.
authors.forename: Loredana
authors.initials: L
authors.lastname: Pagano
authors.forename: Marina
authors.initials: M
authors.lastname: Caputo
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Samà
authors.forename: Marco
authors.initials: M
authors.lastname: Zavattaro
authors.forename: Flavia
authors.initials: F
authors.lastname: Prodam
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Mauri
authors.forename: Francesco
authors.initials: F
authors.lastname: Pia
authors.forename: Amedeo
authors.initials: A
authors.lastname: Alonzo
authors.forename: Guido
authors.initials: G
authors.lastname: Valente
authors.forename: Gianluca
authors.initials: G
authors.lastname: Aimaretti
mesh_terms: D000328:Adult; D002291:Carcinoma, Papillary / Q000378:metabolism / Q000473:pathology* / Q000556:secondary / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D009154:Mutation; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics / Q000378:metabolism; D012878:Skin Neoplasms / Q000556:secondary* / Q000628:therapy; D040521:Subcutaneous Tissue / Q000473:pathology*; D013953:Thymus Neoplasms / Q000556:secondary* / Q000628:therapy; D013964:Thyroid Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000628:therapy
chemical_list: C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf
keywords: BRAF analysis; papillary thyroid carcinoma; subcutaneous metastases; tall cell variant; thymic metastases