212002 Metastatic carcinoma of the thyroid gland:as report of 35 cases

/Yu Yue(于躍，Dept Head Neck Surg，Cancer Hosp，Peking Union Med，Chin Acad Med Sci，Beijing 100021)…∥Chin J Gen Surg.-2011，26(8).-644～647

ObjectiveTo study the clinical characteristics，diagnosis，treatment and prognosis of cancer metastasis to the thyroid gland.MethodsA restropective review was performed on 35 patients with cancer metastasis to the thyroid gland in our hospital from 1958 to 2010l.Diagnosis was confirmed by fine-needle aspiration cytology or histopathology in all cases.ResultsPrimary tumor origin was identified in all but three cases.The lung was the most common primary tumor site(n=16)，followed by esophagus(n=9)，breast(n=2)，kidney(n=2)，hypopharynx(n=1)，nasopharynx(n=1)and soft palate(n=1).Thyroid metastasis was found before the diagnosis of the primary tumor was established in 12 cases;in the other 23 cases，the time lapse from diagnosis of the primary tumor to metastasis to the thyroid gland ranged from 0-168 months，median 24 months.In 6 patients，this interval was more than 36 months.Fine-needle aspiration cytology(FNAC)confirmed metastatic malignancy in 7 patients，histology in 24，combined application confirmed the diagnosis in 4.After the metastasis to the thyroid gland was established，the median survival time for the entire group was 11.5 months，the 1- ，3-and 5-year survival rate was 43.8%，27.8%and 11.9%，respectively.28 patients were treated surgically，and 7 received nonsurgical group(P ＜0.01).In those patients with metastatic cervical lymph nodes，median survival time did not vary from patients undergoing thyroidectomy with neck dissection to those undergoing thyroidectomhy alone(P ＞0.05).ConclusionMetastasis of carcinoma to the thyroid gland has an occult occurrence，thyroid metastases can be detected conclusively with FNAC.Metastasis to the thyroid gland implies advanced malignant tumors，often with poor prognosis.11 refs，2 figs，1 tab.