Papillary thyroid microcarcinoma with multiple pulmonary metastases following lung cancer surgery: a case report
Abstract Background Distant metastasis is extremely rare for papillary thyroid microcarcinoma (PTMC) without lymph node metastasis or extrathyroidal extension, for which active surveillance (AS) is indicated. The evaluation of distant metastases in low-risk PTMC is controversial. A case of PTMC in w...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2022-12-01
|
| Series: | Surgical Case Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40792-022-01570-y |
| _version_ | 1828170328313954304 |
|---|---|
| author | Hidenori Kamio Hiromi Onizuka Yusaku Yoshida Yoko Omi Tamami Isaka Yoji Nagashima Kiyomi Horiuchi Takahiro Okamoto |
| author_facet | Hidenori Kamio Hiromi Onizuka Yusaku Yoshida Yoko Omi Tamami Isaka Yoji Nagashima Kiyomi Horiuchi Takahiro Okamoto |
| author_sort | Hidenori Kamio |
| collection | DOAJ |
| description | Abstract Background Distant metastasis is extremely rare for papillary thyroid microcarcinoma (PTMC) without lymph node metastasis or extrathyroidal extension, for which active surveillance (AS) is indicated. The evaluation of distant metastases in low-risk PTMC is controversial. A case of PTMC in which AS would have been performed if chest CT and lung surgery had not been performed is reported. Case presentation The patient was a 71-year-old woman undergoing follow-up in the Department of Thoracic Surgery at our hospital for multiple frosted glass shadows in both lung fields for one and a half years. To make a definitive diagnosis, thoracoscopic right middle lobectomy and left upper partial lobectomy were performed 4 and 6 months earlier, respectively. In both resected specimens, lung adenocarcinoma and small metastasis of papillary thyroid carcinoma (PTC) were found. The patient was transferred to our department for a thorough examination for PTC. Ultrasonography was performed to search for the primary lesion, and it showed an irregular hypoechoic mass of 4 mm and 6 mm in the middle of the right lobe of the thyroid gland. The patient was diagnosed with PTC. Its clinical stage was T1a (m) N0 M1 (stage IVC). Total thyroidectomy and prophylactic central node dissection were performed. The pathological diagnosis was PTC (typical type) pT1a (m) N0. Postoperatively, she received radioactive iodine therapy. Conclusions We experienced an extremely rare case and struggled to determine a treatment plan. We might be aware that lung metastases could develop in low-risk PTMC. |
| first_indexed | 2024-04-12T03:06:56Z |
| format | Article |
| id | doaj.art-275055284bd146ba8b7ea8adf2c61a9c |
| institution | Directory Open Access Journal |
| issn | 2198-7793 |
| language | English |
| last_indexed | 2024-04-12T03:06:56Z |
| publishDate | 2022-12-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj.art-275055284bd146ba8b7ea8adf2c61a9c2022-12-22T03:50:28ZengSpringerOpenSurgical Case Reports2198-77932022-12-01811510.1186/s40792-022-01570-yPapillary thyroid microcarcinoma with multiple pulmonary metastases following lung cancer surgery: a case reportHidenori Kamio0Hiromi Onizuka1Yusaku Yoshida2Yoko Omi3Tamami Isaka4Yoji Nagashima5Kiyomi Horiuchi6Takahiro Okamoto7Department of Endocrine Surgery, Tokyo Women’s Medical UniversityDepartment of Surgical Pathology, Tokyo Women’s Medical UniversityDepartment of Endocrine Surgery, Tokyo Women’s Medical UniversityDepartment of Endocrine Surgery, Tokyo Women’s Medical UniversityDepartment of Thoracic Surgery, Tokyo Women’s Medical UniversityDepartment of Surgical Pathology, Tokyo Women’s Medical UniversityDepartment of Endocrine Surgery, Tokyo Women’s Medical UniversityDepartment of Endocrine Surgery, Tokyo Women’s Medical UniversityAbstract Background Distant metastasis is extremely rare for papillary thyroid microcarcinoma (PTMC) without lymph node metastasis or extrathyroidal extension, for which active surveillance (AS) is indicated. The evaluation of distant metastases in low-risk PTMC is controversial. A case of PTMC in which AS would have been performed if chest CT and lung surgery had not been performed is reported. Case presentation The patient was a 71-year-old woman undergoing follow-up in the Department of Thoracic Surgery at our hospital for multiple frosted glass shadows in both lung fields for one and a half years. To make a definitive diagnosis, thoracoscopic right middle lobectomy and left upper partial lobectomy were performed 4 and 6 months earlier, respectively. In both resected specimens, lung adenocarcinoma and small metastasis of papillary thyroid carcinoma (PTC) were found. The patient was transferred to our department for a thorough examination for PTC. Ultrasonography was performed to search for the primary lesion, and it showed an irregular hypoechoic mass of 4 mm and 6 mm in the middle of the right lobe of the thyroid gland. The patient was diagnosed with PTC. Its clinical stage was T1a (m) N0 M1 (stage IVC). Total thyroidectomy and prophylactic central node dissection were performed. The pathological diagnosis was PTC (typical type) pT1a (m) N0. Postoperatively, she received radioactive iodine therapy. Conclusions We experienced an extremely rare case and struggled to determine a treatment plan. We might be aware that lung metastases could develop in low-risk PTMC.https://doi.org/10.1186/s40792-022-01570-yLow-risk papillary thyroid microcarcinoma (PTMC)Active surveillance (AS)Distant metastasis |
| spellingShingle | Hidenori Kamio Hiromi Onizuka Yusaku Yoshida Yoko Omi Tamami Isaka Yoji Nagashima Kiyomi Horiuchi Takahiro Okamoto Papillary thyroid microcarcinoma with multiple pulmonary metastases following lung cancer surgery: a case report Surgical Case Reports Low-risk papillary thyroid microcarcinoma (PTMC) Active surveillance (AS) Distant metastasis |
| title | Papillary thyroid microcarcinoma with multiple pulmonary metastases following lung cancer surgery: a case report |
| title_full | Papillary thyroid microcarcinoma with multiple pulmonary metastases following lung cancer surgery: a case report |
| title_fullStr | Papillary thyroid microcarcinoma with multiple pulmonary metastases following lung cancer surgery: a case report |
| title_full_unstemmed | Papillary thyroid microcarcinoma with multiple pulmonary metastases following lung cancer surgery: a case report |
| title_short | Papillary thyroid microcarcinoma with multiple pulmonary metastases following lung cancer surgery: a case report |
| title_sort | papillary thyroid microcarcinoma with multiple pulmonary metastases following lung cancer surgery a case report |
| topic | Low-risk papillary thyroid microcarcinoma (PTMC) Active surveillance (AS) Distant metastasis |
| url | https://doi.org/10.1186/s40792-022-01570-y |
| work_keys_str_mv | AT hidenorikamio papillarythyroidmicrocarcinomawithmultiplepulmonarymetastasesfollowinglungcancersurgeryacasereport AT hiromionizuka papillarythyroidmicrocarcinomawithmultiplepulmonarymetastasesfollowinglungcancersurgeryacasereport AT yusakuyoshida papillarythyroidmicrocarcinomawithmultiplepulmonarymetastasesfollowinglungcancersurgeryacasereport AT yokoomi papillarythyroidmicrocarcinomawithmultiplepulmonarymetastasesfollowinglungcancersurgeryacasereport AT tamamiisaka papillarythyroidmicrocarcinomawithmultiplepulmonarymetastasesfollowinglungcancersurgeryacasereport AT yojinagashima papillarythyroidmicrocarcinomawithmultiplepulmonarymetastasesfollowinglungcancersurgeryacasereport AT kiyomihoriuchi papillarythyroidmicrocarcinomawithmultiplepulmonarymetastasesfollowinglungcancersurgeryacasereport AT takahirookamoto papillarythyroidmicrocarcinomawithmultiplepulmonarymetastasesfollowinglungcancersurgeryacasereport |