title: Outcome and characteristics of patients with malignant pleural effusion from differentiated thyroid carcinoma.
abstract: Metastatic differentiated thyroid carcinoma (DTC) is an uncommon cause of malignant pleural effusion (MPE) and the characteristics and clinical course have been rarely described. Herein, we report a retrospective review of the clinical course of 18 patients (15 women and 3 men) with MPE from DTC who underwent treatment at our institution between January 2005 and December 2014. MPE from DTC was diagnosed based on cytology and/or level of thyroglobulin in the pleural fluid. Pathologically, papillary carcinoma was found in 16 patients and follicular carcinoma in 2 patients. Median ages at initial diagnosis of DTC and MPE were 64 years (range, 22-79) and 74 years (range, 39-86), respectively. All patients showed radiologically apparent lung metastases, with MPE developing after 0-212 months (median, 25). In 16 patients (88.9%), other coexistent distant metastases at the time of MPE diagnosis were found in the bone (n = 10), brain (n = 5), and skin (n = 2). All patients were treated conservatively with palliative thoracentesis or chest tube drainage with or without pleurodesis. Recurrent MPE after treatment was seen in 9 patients; discharge to home health care after treatment for MPE was possible for 14 patients. The overall survival after initial diagnosis varied considerably from 14 months to 37 years, but the median survival after appearance of MPE was 10 months (range, 1-28). Systemic therapy for iodine-resistant recurrent thyroid disease may need to be considered as a treatment option for patients with MPE.
authors.affiliation: Department of Surgery, Ito Hospital, Tokyo 150-8308, Japan.
authors.forename: Chisato
authors.initials: C
authors.lastname: Tomoda
authors.forename: Yuna
authors.initials: Y
authors.lastname: Ogimi
authors.forename: Fumi
authors.initials: F
authors.lastname: Saito
authors.forename: Chie
authors.initials: C
authors.lastname: Masaki
authors.forename: Junko
authors.initials: J
authors.lastname: Akaishi
authors.forename: Kenichi
authors.initials: K
authors.lastname: Matsuzu
authors.forename: Akifumi
authors.initials: A
authors.lastname: Suzuki
authors.forename: Takashi
authors.initials: T
authors.lastname: Uruno
authors.forename: Keiko
authors.initials: K
authors.lastname: Ohkuwa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shibuya
authors.forename: Wataru
authors.initials: W
authors.lastname: Kitagawa
authors.forename: Mitsuji
authors.initials: M
authors.lastname: Nagahama
authors.forename: Kiminori
authors.initials: K
authors.lastname: Sugino
authors.forename: Koichi
authors.initials: K
authors.lastname: Ito
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000473:pathology / Q000503:physiopathology* / Q000556:secondary / Q000601:surgery; D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D002291:Carcinoma, Papillary / Q000473:pathology / Q000503:physiopathology* / Q000556:secondary / Q000601:surgery; D005260:Female; D006786:Hospitals, Urban; D006801:Humans; D007564:Japan; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000556:secondary* / Q000628:therapy; D008197:Lymph Node Excision / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care; D016066:Pleural Effusion, Malignant / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D000077273:Thyroid Cancer, Papillary; D013961:Thyroid Gland / Q000473:pathology* / Q000601:surgery; D013964:Thyroid Neoplasms / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D013965:Thyroidectomy / Q000009:adverse effects; D055815:Young Adult