Initial clinical presentation of single soft tissue metastasis of medullary thyroid carcinoma without primary tumor in the thyroid gland
Abstract Background Single soft tissue metastasis of medullary thyroid carcinoma is extremely rare. In addition, several occult medullary thyroid carcinomas with distant metastasis were reported, but undetectable primary lesion at diagnosis was also extremely rare. Case presentation A 74-year-old ma...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2017-12-01
|
| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12957-017-1293-2 |
| _version_ | 1819265836857163776 |
|---|---|
| author | Masanori Okamoto Akira Takazawa Kaoru Aoki Yasuo Yoshimura Hiroyuki Kato Toshiaki Otsuki Kazuma Maeno Tomonobu Koizumi |
| author_facet | Masanori Okamoto Akira Takazawa Kaoru Aoki Yasuo Yoshimura Hiroyuki Kato Toshiaki Otsuki Kazuma Maeno Tomonobu Koizumi |
| author_sort | Masanori Okamoto |
| collection | DOAJ |
| description | Abstract Background Single soft tissue metastasis of medullary thyroid carcinoma is extremely rare. In addition, several occult medullary thyroid carcinomas with distant metastasis were reported, but undetectable primary lesion at diagnosis was also extremely rare. Case presentation A 74-year-old man was admitted to our hospital because of a painful nodule in his left buttock for over 1 year. Needle biopsy was performed, and the histological findings revealed adenocarcinoma positive for thyroid transcription factor-1. No evidence of a primary tumor, including the lung and thyroid gland, could be found elsewhere despite detailed examinations, including thyroid echography, chest computed tomography, and fluorodeoxyglucose-positron emission tomography. The soft tissue tumor was resected with a wide margin. Immunohistochemical analysis showed the tumor cells to be positive for cytokeratin-AE1/3, cytokeratin 7, synaptophysin, chromogranin A, calcitonin, and carcinoembryonic antigen, but negative for cytokeratin 20, Napsin A, Pax8, and p40, resulting in a diagnosis of metastasis of medullary thyroid carcinoma. Conclusion Initial presentation with a single metastasis to soft tissue and undetectable primary tumor in the thyroid gland is an extremely rare clinical manifestation in patients with medullary thyroid carcinoma. |
| first_indexed | 2024-12-23T20:51:43Z |
| format | Article |
| id | doaj.art-2cd91904838146698414a65b33788a7f |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-12-23T20:51:43Z |
| publishDate | 2017-12-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-2cd91904838146698414a65b33788a7f2022-12-21T17:31:38ZengBMCWorld Journal of Surgical Oncology1477-78192017-12-011511510.1186/s12957-017-1293-2Initial clinical presentation of single soft tissue metastasis of medullary thyroid carcinoma without primary tumor in the thyroid glandMasanori Okamoto0Akira Takazawa1Kaoru Aoki2Yasuo Yoshimura3Hiroyuki Kato4Toshiaki Otsuki5Kazuma Maeno6Tomonobu Koizumi7Department of Orthopaedic Surgery, Shinshu University School of MedicineDepartment of Orthopaedic Surgery, Shinshu University School of MedicineDepartment of Orthopaedic Surgery, Shinshu University School of MedicineDepartment of Orthopaedic Surgery, Shinshu University School of MedicineDepartment of Orthopaedic Surgery, Shinshu University School of MedicineDepartment of Laboratory, Shinshu University School of MedicineDivision of Breast and Endocrine Surgery, Department of Surgery, Shinshu University School of MedicineDepartment of Comprehensive Cancer Therapy, Shinshu University School of MedicineAbstract Background Single soft tissue metastasis of medullary thyroid carcinoma is extremely rare. In addition, several occult medullary thyroid carcinomas with distant metastasis were reported, but undetectable primary lesion at diagnosis was also extremely rare. Case presentation A 74-year-old man was admitted to our hospital because of a painful nodule in his left buttock for over 1 year. Needle biopsy was performed, and the histological findings revealed adenocarcinoma positive for thyroid transcription factor-1. No evidence of a primary tumor, including the lung and thyroid gland, could be found elsewhere despite detailed examinations, including thyroid echography, chest computed tomography, and fluorodeoxyglucose-positron emission tomography. The soft tissue tumor was resected with a wide margin. Immunohistochemical analysis showed the tumor cells to be positive for cytokeratin-AE1/3, cytokeratin 7, synaptophysin, chromogranin A, calcitonin, and carcinoembryonic antigen, but negative for cytokeratin 20, Napsin A, Pax8, and p40, resulting in a diagnosis of metastasis of medullary thyroid carcinoma. Conclusion Initial presentation with a single metastasis to soft tissue and undetectable primary tumor in the thyroid gland is an extremely rare clinical manifestation in patients with medullary thyroid carcinoma.http://link.springer.com/article/10.1186/s12957-017-1293-2Primary unknown originCalcitoninTTF-1Soft tissue metastasisCEA |
| spellingShingle | Masanori Okamoto Akira Takazawa Kaoru Aoki Yasuo Yoshimura Hiroyuki Kato Toshiaki Otsuki Kazuma Maeno Tomonobu Koizumi Initial clinical presentation of single soft tissue metastasis of medullary thyroid carcinoma without primary tumor in the thyroid gland World Journal of Surgical Oncology Primary unknown origin Calcitonin TTF-1 Soft tissue metastasis CEA |
| title | Initial clinical presentation of single soft tissue metastasis of medullary thyroid carcinoma without primary tumor in the thyroid gland |
| title_full | Initial clinical presentation of single soft tissue metastasis of medullary thyroid carcinoma without primary tumor in the thyroid gland |
| title_fullStr | Initial clinical presentation of single soft tissue metastasis of medullary thyroid carcinoma without primary tumor in the thyroid gland |
| title_full_unstemmed | Initial clinical presentation of single soft tissue metastasis of medullary thyroid carcinoma without primary tumor in the thyroid gland |
| title_short | Initial clinical presentation of single soft tissue metastasis of medullary thyroid carcinoma without primary tumor in the thyroid gland |
| title_sort | initial clinical presentation of single soft tissue metastasis of medullary thyroid carcinoma without primary tumor in the thyroid gland |
| topic | Primary unknown origin Calcitonin TTF-1 Soft tissue metastasis CEA |
| url | http://link.springer.com/article/10.1186/s12957-017-1293-2 |
| work_keys_str_mv | AT masanoriokamoto initialclinicalpresentationofsinglesofttissuemetastasisofmedullarythyroidcarcinomawithoutprimarytumorinthethyroidgland AT akiratakazawa initialclinicalpresentationofsinglesofttissuemetastasisofmedullarythyroidcarcinomawithoutprimarytumorinthethyroidgland AT kaoruaoki initialclinicalpresentationofsinglesofttissuemetastasisofmedullarythyroidcarcinomawithoutprimarytumorinthethyroidgland AT yasuoyoshimura initialclinicalpresentationofsinglesofttissuemetastasisofmedullarythyroidcarcinomawithoutprimarytumorinthethyroidgland AT hiroyukikato initialclinicalpresentationofsinglesofttissuemetastasisofmedullarythyroidcarcinomawithoutprimarytumorinthethyroidgland AT toshiakiotsuki initialclinicalpresentationofsinglesofttissuemetastasisofmedullarythyroidcarcinomawithoutprimarytumorinthethyroidgland AT kazumamaeno initialclinicalpresentationofsinglesofttissuemetastasisofmedullarythyroidcarcinomawithoutprimarytumorinthethyroidgland AT tomonobukoizumi initialclinicalpresentationofsinglesofttissuemetastasisofmedullarythyroidcarcinomawithoutprimarytumorinthethyroidgland |