Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Obstet Gynecol. Jun 29, 2022; 11(3): 33-39
Published online Jun 29, 2022. doi: 10.5317/wjog.v11.i3.33
Therapeutic challenges in metastatic follicular thyroid cancer occurring in pregnancy: A case report
Claudio Spinelli, Beatrice Sanna, Marco Ghionzoli, Elisabetta Micelli
Claudio Spinelli, Beatrice Sanna, Marco Ghionzoli, Division of Pediatric and Adolescent Surgery, Department of Surgical, Medical, Molecular Pathology and of the Critic Area, University of Pisa, Pisa 56100, Italy
Elisabetta Micelli, Division of Gynecology and Obstetrics, University of Pisa, Pisa 56100, Italy
Author contributions: Spinelli C, Sanna B and Micelli E participated in conception and design, drafting the article and acquisition of data; Sanna B and Ghionzoli M participated in acquisition of data and analysis and interpretation of data; All of the co-authors interpreted the data, participated in the completion of the article, and approved the final version of the article.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marco Ghionzoli, MD, PhD, Attending Doctor, Division of Pediatric and Adolescent Surgery, Department of Surgical, Medical, Molecular Pathology and of the Critic Area, University of Pisa, Via Roma 67, Pisa 56100, Italy. marco.ghionzoli@meyer.it
Received: December 28, 2021
Peer-review started: December 28, 2021
First decision: March 16, 2022
Revised: March 22, 2022
Accepted: May 28, 2022
Article in press: May 28, 2022
Published online: June 29, 2022
Abstract
BACKGROUND

Hormones could play a role in the evolution of follicular thyroid cancer (FTC) for which we discuss an unusual presentation of FTC occurring during pregnancy.

CASE SUMMARY

A pregnant woman was admitted with FTC metastasis resulting in a gluteal mass. Preoperative abdominal computed tomography revealed liver metastasis for which the patient underwent total thyroidectomy and liver resection, oral radioiodine therapy and radiotherapy, followed by embolization of the pelvic mass. The patient died of cerebral hemorrhage 16 mo after the initial diagnosis.

CONCLUSION

Human chorionic gonadotropin and estrogen stimulation might have a role in cancer growth, especially during pregnancy. FTC management aims to stop disease progression and overcome hormonal imbalances after thyroidectomy thus reducing fetal complications. It is still under debate whether it is possible to combine optimal timing for treatment to ensure the best possible outcome with reduction of fetal complications and risk of cancer growth.

Keywords: Gluteal pain, Follicular thyroid cancer, Metastases, Pregnancy, Unusual presentation, Case report

Core Tip: We discuss an uncommon presentation of follicular thyroid cancer occurring during pregnancy. Beta human chorionic gonadotropin and estrogens could take part in the progression of thyroid tumors.