Diffuse Metastasis to the Thyroid: Unique Ultrasonographic Finding and Clinical Correlation.
10.3346/jkms.2014.29.6.818
- Author:
Hee Kyung KIM
1
;
Sung Sun KIM
;
Chan Young OAK
;
Soo Jeong KIM
;
Jee Hee YOON
;
Ho Cheol KANG
Author Information
1. Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea. drkang@chonnam.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Thyroid;
Diffuse;
Metastasis;
Ultrasonography;
Fine Needle Aspiration Cytology
- MeSH:
Aged;
Bile Duct Neoplasms/pathology;
Biopsy, Fine-Needle;
Cholangiocarcinoma/pathology;
Female;
Fluorodeoxyglucose F18/diagnostic use;
Humans;
Hypothyroidism/complications;
Lung Neoplasms/pathology;
Male;
Middle Aged;
Penile Neoplasms/pathology;
Positron-Emission Tomography;
Radiopharmaceuticals/diagnostic use;
Thyroid Function Tests;
Thyroid Gland/pathology/*ultrasonography;
Thyroid Neoplasms/pathology/secondary/*ultrasonography
- From:Journal of Korean Medical Science
2014;29(6):818-824
- CountryRepublic of Korea
- Language:English
-
Abstract:
Cases of metastases to the thyroid gland seem to be increasing in recent years. The clinical and ultrasonographic findings of diffuse metastases have been sparsely reported. Thirteen cases of diffuse metastases to the thyroid gland were documented by thyroid ultrasonography-guided fine needle aspiration cytology between 2004 and 2013. We retrospectively reviewed the patients with diffuse thyroid metastases. The most common primary site was the lung (n=9), followed by unknown origin cancers (n=2), cholangiocarcinoma (n=1), and penile cancer (n=1). Eleven patients were incidentally found to have thyroid metastases via surveillance or staging FDG-PET. Other 2 patients were diagnosed during work-up for hypothyroidism and palpable cervical lymph nodes. On ultrasonography, the echogenicity of the enlarged thyroid gland was heterogeneously hypoechoic or isoechoic, and reticular pattern internal hypoechoic lines were observed without increased vascularity found by power Doppler ultrasonography (3 right lobe, 2 left lobe, and 8 both lobes). In the 8 patients who had involvement of both lobes, 3 had hypothyroidism. In conclusion, ultrasonographic finding of diffuse metastasis is a diffusely enlarged heterogeneous thyroid with reticular pattern internal hypoechoic lines. Thyroid function testing should be performed in all patients with diffuse thyroid metastases, especially those with bilateral lobe involvement.
