Yang CY, Chen XW, Tang D, Yang WJ, Mi XX, Shi JP, Du WD. Hepatopulmonary metastases from papillary thyroid microcarcinoma: A case report. World J Clin Cases 2022; 10(14): 4661-4668 [PMID: 35663055 DOI: 10.12998/wjcc.v10.i14.4661]
Corresponding Author of This Article
Wei-Dong Du, MD, Chief Physician, Department of Hepatobiliary Surgery, The First Clinical Medical College of Zhejiang Chinese Medical University, No. 54 Youdian Road, Shangcheng District, Hangzhou 310003, Zhejiang Province, China. hzadu@163.com
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Chuan-Yu Yang, Xuan-Wu Chen, Wei-Dong Du, Department of Hepatobiliary Surgery, The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou 310003, Zhejiang Province, China
Dong Tang, Department of Medical Imaging, The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, Zhejiang Province, China
Wen-Jun Yang, Department of Pathology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, Zhejiang Province, China
Xiao-Xiao Mi, Jun-Ping Shi, Institute of Translational Medicine, The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, Zhejiang Province, China
Author contributions: Yang CY and Chen XW provided the case; Tang D performed radiological imaging analysis; Yang WJ performed pathological imaging analysis; Yang CY was involved in the biomedical analysis; Yang CY and Mi XX wrote the manuscript with input from Chen XW, Tang D and Yang WJ; Du WD and Shi JP revised the manuscript; all authors have contributed significantly.
Supported bythe Joint Funds of the Zhejiang Provincial Natural Science Foundation of China, No. LBY21H030001; and the Science and Technology Planning Project of Zhejiang Province, No. 2020KY708.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no competing interests.
CARE Checklist (2016) statement: Our case report is written according to 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: Wei-Dong Du, MD, Chief Physician, Department of Hepatobiliary Surgery, The First Clinical Medical College of Zhejiang Chinese Medical University, No. 54 Youdian Road, Shangcheng District, Hangzhou 310003, Zhejiang Province, China. hzadu@163.com
Received: December 1, 2021 Peer-review started: December 1, 2021 First decision: January 12, 2022 Revised: January 18, 2022 Accepted: March 16, 2022 Article in press: March 16, 2022 Published online: May 16, 2022
Abstract
BACKGROUND
Papillary thyroid carcinoma (PTC) is the most common endocrine malignancy. Papillary thyroid microcarcinoma (PTMC) accounts for the majority of PTC cases. However, concurrent pulmonary and hepatic metastases of PTMC are rarely seen. Here, we present a patient with coexisting liver and lung metastases from PTMC.
CASE SUMMARY
We describe a 26-year-old woman with PTMC with multiple concurrent metastases. After 3 d of unexplained fever, she was admitted to our hospital. Her thyroid functional tests were abnormal. Her positron emission tomography (PET)/magnetic resonance imaging (MRI) examination showed increased fluorodeoxyglucose (FDG) metabolism and space-occupying lesions in the left lobe of the thyroid. Additionally, PET/MRI images revealed multiple nodules in the lung and liver with increased FDG metabolism. Chest computer tomography (CT) showed multiple pulmonary metastases. Abdominal ultrasound and liver MRI showed multiple space-occupying lesions in the liver. The patient underwent total thyroidectomy and central lymph node dissection. Postoperative pathological analysis showed a papillary microcarcinoma multiplex in the left lobe of the thyroid. A diagnosis of hepatopulmonary metastases from papillary thyroid microcarcinoma was made. The patient was given iodine-131 treatment one year after the surgery. She recovered well after the operation, and the incision healed well. After discharge, she was treated with oral levothyroxine sodium tablets, and symptomatic and supportive treatments were also given to promote radioactive excretion and prevent bone marrow suppression by iodine-131 treatment.
CONCLUSION
Since patients with thyroid cancer concurrent with hepatopulmonary metastases have rarely been reported, our case will highlight the clinical and pathological profiles of these patients.
Core Tip: Concurrent pulmonary and hepatic metastases of papillary thyroid microcarcinoma are not often seen due to their rarity and nonspecific presentations. Herein, we provided a successful example of the diagnosis and treatment of pulmonary and hepatic metastases of papillary thyroid microcarcinoma in a young female patient. Our case emphasizes that distant metastases of papillary thyroid carcinoma can occur in young patients.
