Subcentimetric papillary thyroid carcinoma with extensive lymph node and brain metastasis: case report and review of literature

被引:1
作者
Amado, Andreia [1 ]
Teixeira, Elisabete [2 ,3 ,4 ]
Canberk, Sule [2 ,3 ,4 ]
Macedo, Sofia [2 ,3 ,6 ]
Castro, Barbara [1 ]
Pereira, Hugo [1 ]
Varanda, Joao [1 ]
Graca, Susana [1 ]
Tavares, Amelia [1 ,2 ,3 ,4 ]
Soares, Carlos [1 ]
Oliveira, Maria Joao [1 ]
Oliveira, Manuel [1 ]
Soares, Paula [2 ,3 ,4 ]
Simoes, Manuel Sobrinho [2 ,3 ,4 ,5 ]
Povoa, Antonia Afonso [1 ,2 ,3 ,4 ]
机构
[1] Ctr Hosp Vila Nova de Gaia Espinho, Rua Conceicao Fernandes S-N, P-4434502 Vila Nova De Gaia, Portugal
[2] Univ Porto, I3S Inst Invest & Inovacao Saude, R Alfredo Allen 208, P-4200135 Porto, Portugal
[3] Univ Porto, IPATIMUP Inst Patol & Imunol Mol, Rua Julio Amaral de Carvalho 45, P-4200135 Porto, Portugal
[4] Univ Porto, Fac Med, Alameda Prof Hernani Monteiro, P-4200319 Porto, Portugal
[5] Ctr Hosp Univ Sao Joao, Alameda Prof Hernani Monteiro, P-4200319 Porto, Portugal
[6] Univ Porto, Inst Ciencias Biomed Abel Salazar, R Jorge de Viterbo Ferreira 228, P-4050313 Porto, Portugal
关键词
Geriatric; Male; White; Portugal; Thyroid; Genetics and mutation; Endocrine-related cancer; Unique/unexpected symptoms or presentations of a disease; December; 2023; TERT PROMOTER MUTATIONS; CEREBELLAR METASTASIS; CANCER; MICROCARCINOMA; GUIDELINES; MANAGEMENT; INSIGHTS; FEATURES; BONE;
D O I
10.1530/EDM-23-0025
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
We report a 61-year-old male patient without personal history of thyroid carcinoma or radiation exposure. In 2011, he presented with a cervical mass whose biopsy diagnosed a papillary thyroid carcinoma (PTC) in a lymph node metastasis (LNM). Total thyroidectomy with lymphadenectomy of central and ipsilateral compartment was performed. Histopathology identified a 2 mm follicular variant of PTC and LNM in 25/25 lymph nodes. The patient was treated with 150 mCi of radioactive iodine (RAI), followed by levothyroxine suppressive therapy. In 2016, a retrotracheal mass was diagnosed, suggesting local recurrence; patient was submitted to surgical excision and RAI therapy (120 mCi). Due to seizures, in 2019, a brain CT was performed that diagnosed brain metastases. The patient underwent debulking of the main lesion. Histopathology analysis confirmed a metastatic lesion with variated morphology: classical PTC and follicular pattern and hobnail and tall cell features. Molecular analysis revealed BRAFV600E in LNM at presentation and BRAFV600E and TERT promoter (TERTp) mutations in the recurrent LNM and brain metastasis. Based upon this experience we review the reported cases of subcentimetric PTC with brain metastases and discuss the molecular progression of the present case.
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页数:7
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