Isolated Metastasis of the Ascending Ramus of the Mandible of Thyroid Follicular Carcinoma: A Case Report and Literature Review

Objectives: The mandibular metastatic spread of carcinoma from the thyroid gland is exceedingly rare. In August 2020, we treated a 69-year-old woman exhibiting thyroid follicular carcinoma metastasis to the ascending ramus region of the mandible showing evidence of detailed radiological and pathological features. Methods: We present a case report of thyroid carcinoma that metastasized to the ascending ramus region of the mandible at 21 years after partial thyroidectomy. We also present relevant information in a literature review of 35 articles, consisting of 43 cases (including our case) of thyroid carcinomas with jaw bone metastasis. We statistically analyzed the demographical and clinical results in terms of age, sex, type of primary cancer, site and time of metastasis, treatment, and outcome.Results: Unlike most of the other cases, in our case, the thyroid cancer had metastasized to the ascending ramus region of the mandible, which made the diagnosis relatively difficult. The patient underwent partial mandibular resection, thyroidectomy, and iodine-131 treatment. The patient was followed up regularly, and no new symptoms were observed at seven months after post-treatment.Conclusions: Surgery is the most common treatment for thyroid metastases of the mandible. Clinicians should ask thyroid cancer patients for follow-up to monitor whether any new complications have occurred. Patients must undergo complete examination of the maxillofacial bone for up to 40 years or more. Otolaryngologists and stomatologists should pay extra attention to patients with thyroid cancer or nodules to avoid misdiagnosis or missing the recognition of thyroid metastatic cancer.

Needle Tract Seeding of Thyroid Follicular Carcinoma after Fine-Needle Aspiration

Introduction. Fine-needle aspiration (FNA) biopsies are fundamental procedures in the diagnoses of thyroid tumours. Reports of needle tract tumour seeding, however, question its practice regarding patient safety and potentially jeopardizing its widespread usage. Case Report. We describe a case of a 50-year-old lady with known multinodular goitre, and previous fine-needle aspiration (FNA) biopsies of her thyroid nodules in 2010, who developed palpable right neck nodules 8 years after the initial FNA. Imaging and histological biopsies revealed suspicious right sternocleidomastoid (SCM) nodules that are likely needle tract tumour deposits. She underwent a total thyroidectomy with central compartment clearance and excision of the right SCM nodules and received radioactive iodine therapy thereafter. Discussion. Contrary to other forms of malignancies, needle tract seeding is an uncommon occurrence for thyroid cancers. Nevertheless, there is speculation regarding its potential in cutaneous spread of malignancy with studies investigating its optimal techniques and application. Conclusion. While FNA remains an indisputable tool in the management of thyroid tumours, precautions must be taken to safeguard patient safety and improve patient outcomes.

Advanced Thyroid Follicular Carcinoma in a Pregnant Woman

The diagnostic and therapeutic approach for pregnant women with thyroid nodules can present a challenge, especially concerning surgical procedures. In the context of malignant diagnosis, by fine needle aspiration (FNA), during pregnancy, the uncertainty lies in performing surgery. This article reports the case of a 41-year-old pregnant woman in her first gestation, who sought medical care complaining of right shoulder pain. Imaging workup depicted the destruction of the humeral head and involvement of the surrounding soft tissue. She was 20 weeks pregnant. The histological report favored the diagnosis of malignancy and the thyroid as the primary site. At 30 weeks of gestation, the patient underwent a cesarean section, a total thyroidectomy, and total resection of the metastasis. The child was born healthy, but one year after the diagnosis, the patient died. Bone and soft tissue metastasis of thyroid neoplasms are not very common and indicate poor prognosis.

Chest wall metastasis in postoperative thyroid cancer: a case report

Thyroid cancer is common in China. Thyroid adenocarcinoma metastases can be local or distal metastasis. Local metastasis presents as a hard and fixed lymph node in the neck, while distant metastases are found in the lung, skull, vertebrae, and pelvis. However, thyroid follicular carcinomas are mostly observed in hematogenous metastases. The thyroid adenocarcinoma and follicular carcinoma of the thyroid gland are often misdiagnosed. Here, we report the case of a 53-year-old female patient. More than 2 years after her initial diagnosis, her left chest wall was physically examined. The results revealed a progressive enlargement that had a hard quality, poor activity, unclear boundary, pressure pain, and percussion pain. Thyroid follicular cell carcinoma was subsequently diagnosed and treated surgically. The thyroid carcinoma had multiple bone metastases, and the thyroid follicular carcinoma had spread to the chest wall through the blood vessels. Thus, preoperative procedures and follow-up should be strengthened because early pathological thyroid follicular carcinoma and thyroid adenoma can easily be misdiagnosed. Pathologic consultation and follow-ups should be strengthened to prevent misdiagnosis.