scholarly journals Multifocal metastases to choroid plexus from papillary thyroid carcinoma: illustrative case

2021 ◽  
Vol 2 (11) ◽  
Author(s):  
Isidora R. Beach ◽  
Adam M. Olszewski ◽  
Alissa A. Thomas ◽  
John C. DeWitt ◽  
Brandon D. Liebelt
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Choroid Plexus ◽  
Treatment Modalities ◽  
Illustrative Case ◽  
Disease Course ◽  
Papillary Thyroid ◽  
Comfort Care ◽  
The Third ◽  
Plexus Lesion

BACKGROUND Choroid plexus metastases are extremely rare from all types of malignancy, with only 42 cases reported in the literature thus far. Most of these originate from renal cell carcinoma and present as a solitary choroid plexus lesion; only two cases of multifocal choroid plexus metastases have been reported to date. OBSERVATIONS The authors report the third case of multifocal metastases to the choroid plexus, that of a 75-year-old man who developed three measurable choroid plexus lesions approximately 3.5 years after undergoing total thyroidectomy and chemotherapy for papillary thyroid carcinoma. He underwent intraventricular biopsy of the largest lesion and subsequently died of hydrocephalus after opting for comfort care only. LESSONS This is the third case of multifocal choroid plexus metastasis in the literature and the second case of multifocal metastasis from thyroid carcinoma. As such, the natural disease course is not well characterized. This case is compared with the previous eight reports of choroid plexus metastases from thyroid carcinoma, seven of which involved solitary lesions. The eight prior cases are evaluated with attention to treatment modalities used and factors potentially influencing prognosis, specifically those that might contribute to hydrocephalus, a reported complication for this pathology.

scholarly journals ERADICATION OF PAPILLARY THYROID CARCINOMA IN A PATIENT RECEIVING PEMETREXED AND BEVACIZUMAB

2020 ◽  
Vol 6 (5) ◽  
pp. e247-e251
Author(s):  
John Dylan Pate ◽  
Christopher M. Gilbert ◽  
James T. Bonucchi
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Nodular Goiter ◽  
Needle Aspiration ◽  
Pet Scan ◽  
Treatment Modalities ◽  
Serous Carcinoma ◽  
Thyroid Function Tests ◽  
Papillary Thyroid ◽  
Recommended Treatment

Objective: To report a 66-year-old female patient whose medical management for advanced-stage, high-grade serous carcinoma of the ovary (HGSC-O) might have treated concomitant papillary thyroid carcinoma (PTC) diagnosed by fine-needle aspiration (FNA). Methods: Patient evaluation and management consisted of positron emission tomography (PET) scans, thyroid ultrasounds, FNA biopsies, and thyroid function tests. Results: The patient presented to the endocrinology clinic while undergoing treatment for HGSC-O with a PET scan revealing increased uptake in the thyroid gland. Due to the PET scan findings, she underwent a thyroid ultrasound examination which revealed co-existent multi-nodular goiter and a lesion with concerning features. FNA biopsy was read as PTC. Surgical intervention for PTC was delayed due to progression of the ovarian cancer. In the interim, she underwent chemotherapy with a regimen consisting of elesclomol, paclitaxel, pemetrexed (Alimta), carboplatin, gemcitabine (Gemazar), and bevacizumab (Avastin) at varying intervals. After the patient was able to complete near total thyroidectomy, surgical pathology revealed no viable malignancy. Conclusion: We postulate that the patient’s treatment for HGSC-O, namely pemetrexed (Alimta) and bevacizumab (Avastin), had antineoplastic effects against the PTC. These agents are not currently recommended treatment modalities for PTC. This hypothesis should be validated with further studies.

Bilateral Choroid Plexus Metastasis from Papillary Thyroid Carcinoma: Case Report and Review of the Literature

2015 ◽  
Vol 84 (4) ◽  
pp. 1142-1146 ◽  
Author(s):  
Guive Sharifi ◽  
Mehrdad Hosseinzadeh Bakhtevari ◽  
Mohsen Alghasi ◽  
Masood Asghsri Nosari ◽  
Ramin Rahmanzade ◽  
...  
Keyword(s):  
Case Report ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Choroid Plexus ◽  
Papillary Thyroid ◽  
Review Of The Literature

Choroid Plexus Metastasis From Papillary Thyroid Carcinoma Presenting With Intraventricular Hemorrhage

Neurosurgery ◽  
2010 ◽  
Vol 66 (6) ◽  
pp. E1213-E1214 ◽  
Author(s):  
Brian Wasita ◽  
Makoto Sakamoto ◽  
Minoru Mizushima ◽  
Masamichi Kurosaki ◽  
Takashi Watanabe
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Magnetic Resonance ◽  
Thyroid Carcinoma ◽  
Choroid Plexus ◽  
Intraventricular Hemorrhage ◽  
Histopathological Examination ◽  
Nausea And Vomiting ◽  
Papillary Thyroid ◽  
Bleeding Source ◽  
First Case

Abstract OBJECTIVE Metastases to the choroid plexus from extracranial tumors are rare. Kidney, lung, and colon are the common primary origins of choroid plexus metastases. Choroid plexus metastases from thyroid carcinoma are very rare, with only 2 cases reported thus far. We report the third case of choroid plexus metastasis from thyroid carcinoma. CLINICAL PRESENTATION A 75-year-old man presented with severe headache, nausea, and vomiting. He had a history of thyroid carcinoma, which had metastasized to the lymph nodes and lung. Computed tomography, magnetic resonance imaging, and magnetic resonance angiography revealed right intraventricular hemorrhage with mild hydrocephalus, without evidence of a bleeding source. The bleeding source was assumed to be the choroid plexus metastasis in the trigone of the right lateral ventricle (following second admission). INTERVENTION Surgery was performed using a navigation-assisted system. The tumor was entirely removed, including some choroid plexus tissue. A ventriculoperitoneal shunt was also performed to treat the hydrocephalus. Histopathological examination revealed brain metastasis from papillary thyroid carcinoma. Postoperatively, the patient showed good recovery, with nausea and vomiting improved, and gait disturbance diminished. The patient was discharged from the hospital one month later. CONCLUSION Choroid plexus metastasis from papillary thyroid carcinoma is very rare, and this is the first case of intraventricular hemorrhage reported.

scholarly journals Aggressive Disease Course of Papillary Thyroid Carcinoma with Focal Undifferentiated Component: A Case Report

2016 ◽  
Vol 25 (3) ◽  
pp. 134-139
Author(s):  
Saima Riaz ◽  
Humayun Bashir ◽  
Aamna Hassan ◽  
Sajid Mushtaq ◽  
Arif Jamshed ◽  
...  
Keyword(s):  
Case Report ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Disease Course ◽  
Papillary Thyroid ◽  
Aggressive Disease

scholarly journals New Molecular Targeted Therapy and Redifferentiation Therapy for Radioiodine-Refractory Advanced Papillary Thyroid Carcinoma: Literature Review

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Kai-Pun Wong ◽  
Brian Hung-Hin Lang
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Progressive Disease ◽  
Performance Status ◽  
New Drugs ◽  
Phase Iii ◽  
Treatment Modalities ◽  
Targeted Drugs ◽  
Papillary Thyroid ◽  
Radioiodine Ablation

Although the majority of papillary thyroid carcinoma could be successfully managed by complete surgical resection alone or resection followed by radioiodine ablation, a small proportion of patients may develop radioiodine-refractory progressive disease which is not amenable to surgery, local ablative treatment or other treatment modalities. The use of FDG-PET/CT scan for persistent/recurrent disease has improved the accuracy of restaging as well as cancer prognostication. Given that patients with RAI-refractory disease tend to do significantly worse than those with radioiodine-avid or non-progressive disease, an increasing number of phase I and II studies have been conducted to evaluate the efficacy of new molecular targeted drugs such as the tyrosine kinase inhibitors and redifferentiation drugs. The overall response rate of these drugs ranged between 0–53%, depending on whether the patients had been previously treated with these drugs, performance status and extent of disease. However, drug toxicity remains a major concern in administration of target therapies. Nevertheless, there are also ongoing phase III studies evaluating the efficacy of these new drugs. The aim of the review was to summarize and discuss the results of these targeted drugs and redifferentiation agents for patients with progressive, radioiodine-refractory papillary thyroid carcinoma.

Clear Cell Variant of Papillary Thyroid Carcinoma With Associated Anaplastic Thyroid Carcinoma: Description of an Extraordinary Case

2019 ◽  
Vol 27 (6) ◽  
pp. 658-663
Author(s):  
Carl Christofer Juhlin ◽  
Anders Höög
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Clear Cell ◽  
Lung Metastases ◽  
Anaplastic Thyroid Carcinoma ◽  
Treatment Modalities ◽  
External Irradiation ◽  
Papillary Thyroid ◽  
Cell Variant ◽  
Clear Cell Variant

Clear cell change is a rare observation in thyroid cancer, resulting from aberrant cytoplasmic accumulation of lipids, glycogen, or thyroglobulin in the tumor cells. The phenomenon is most common for follicular thyroid neoplasia, with no definite coupling to patient outcome. The clear cell variant of papillary thyroid carcinoma (ccPTC) is even more infrequent—making conclusions regarding prognosis difficult. Single reports describe distant metastases of ccPTCs as well as co-occurrence with anaplastic thyroid carcinoma (ATC). In this report, a case of a therapy-resistant ccPTC dedifferentiating into an ATC is characterized from morphological and immunohistochemical standpoints. The patient was a 79-year-old female presenting with a 45-mm nodule in her right thyroid lobe. A first round of cytology raised the suspicion of PTC, but a repeated biopsy verified an ATC diagnosis. Neoadjuvant doxorubicin and external irradiation therapy was administered, and the patient developed lung metastases concomitantly. A palliative lobectomy was performed, and the final diagnosis was a ccPTC with focal dedifferentiation into an ATC. Intriguingly, the ccPTC component was viable and dominated the lesion. The clear cell morphology stemmed from an accumulation of glycogen, while the anaplastic component was devoid of evident clear cell changes. The case is one of exceedingly few descriptions of a ccPTC that dedifferentiates to an ATC, suggesting that this PTC subtype is not without potential for development of a highly lethal tumor component. Moreover, the partial lack of response to neoadjuvant therapy suggests a possible underlying resistance to aggressive treatment modalities in this particular case.

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