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Papillary thyroid cancer in struma testis with malignant transformation in the lung associated with trisomy 17 successfully treated with total thyroidectomy and radioiodine ablation.

Barakat S, Odem J, Batanian JR, Raza S, Khan UZ - Case Rep Oncol (2014)

Bottom Line: It highlights the difficulties in treating these patients.Surgery to remove cancer foci, followed by radioactive iodine ablation, resulted in an excellent response in our patient.Interestingly, trisomy 17, which has so far been observed only in noninvasive thyroid nodules, was associated with pulmonary metastasis in our patient.

View Article: PubMed Central - PubMed

Affiliation: Department of Endocrinology, St. Agnes Hospital, Baltimore, Md., USA.

ABSTRACT

Background: Struma testis is a rare entity, and there are only few reports on the malignant transformation of a testicular teratoma to papillary thyroid carcinoma in the literature. In this report, we describe the malignant transformation of struma testis with distant lung metastasis associated with trisomy 17 and a coexisting papillary microcarcinoma in the thyroid.

Case report: A 56-year-old man presented after a left orchiectomy for an undescended left testicle. Pathologic examination identified a monodermal teratoma composed of thyroid parenchyma and associated with a 1.7-cm papillary thyroid carcinoma. Further evaluation showed a pulmonary mass on a chest CT scan. Total thyroidectomy revealed a 0.5-mm focus of papillary thyroid cancer, and removal of the lung mass confirmed metastatic papillary thyroid cancer. Array-comparative genomic hybridization of both tumors showed trisomy 17 in the struma testes and the lung metastasis. The patient responded well to radioactive iodine ablation and has no evidence of cancer 3 years later.

Conclusion: To our knowledge, this is the first case of papillary thyroid cancer in struma testes metastatic to the lung. It highlights the difficulties in treating these patients. Surgery to remove cancer foci, followed by radioactive iodine ablation, resulted in an excellent response in our patient. Interestingly, trisomy 17, which has so far been observed only in noninvasive thyroid nodules, was associated with pulmonary metastasis in our patient.

No MeSH data available.


Related in: MedlinePlus

Papillary thyroid cancer metastasis to the lung with a predominantly follicular pattern. The healthy lung is visible adjacent to the tumor. H&E. ×2 and ×10.
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Figure 2: Papillary thyroid cancer metastasis to the lung with a predominantly follicular pattern. The healthy lung is visible adjacent to the tumor. H&E. ×2 and ×10.

Mentions: A video-assisted thoracoscopic wedge biopsy of the right lower lobe nodule revealed metastatic papillary thyroid carcinoma. Due to concerns about the effectiveness of I-131 ablation in the presence of a right lower lobe mass, the decision was made to perform open right lower lobectomy. A wedge resection of the right upper lobe nodule was also performed. The pathology report of all specimens confirmed papillary thyroid cancer, with a maximum tumor size of 2.1 cm in the right lower lung lobe (fig. 2).


Papillary thyroid cancer in struma testis with malignant transformation in the lung associated with trisomy 17 successfully treated with total thyroidectomy and radioiodine ablation.

Barakat S, Odem J, Batanian JR, Raza S, Khan UZ - Case Rep Oncol (2014)

Papillary thyroid cancer metastasis to the lung with a predominantly follicular pattern. The healthy lung is visible adjacent to the tumor. H&E. ×2 and ×10.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4264490&req=5

Figure 2: Papillary thyroid cancer metastasis to the lung with a predominantly follicular pattern. The healthy lung is visible adjacent to the tumor. H&E. ×2 and ×10.
Mentions: A video-assisted thoracoscopic wedge biopsy of the right lower lobe nodule revealed metastatic papillary thyroid carcinoma. Due to concerns about the effectiveness of I-131 ablation in the presence of a right lower lobe mass, the decision was made to perform open right lower lobectomy. A wedge resection of the right upper lobe nodule was also performed. The pathology report of all specimens confirmed papillary thyroid cancer, with a maximum tumor size of 2.1 cm in the right lower lung lobe (fig. 2).

Bottom Line: It highlights the difficulties in treating these patients.Surgery to remove cancer foci, followed by radioactive iodine ablation, resulted in an excellent response in our patient.Interestingly, trisomy 17, which has so far been observed only in noninvasive thyroid nodules, was associated with pulmonary metastasis in our patient.

View Article: PubMed Central - PubMed

Affiliation: Department of Endocrinology, St. Agnes Hospital, Baltimore, Md., USA.

ABSTRACT

Background: Struma testis is a rare entity, and there are only few reports on the malignant transformation of a testicular teratoma to papillary thyroid carcinoma in the literature. In this report, we describe the malignant transformation of struma testis with distant lung metastasis associated with trisomy 17 and a coexisting papillary microcarcinoma in the thyroid.

Case report: A 56-year-old man presented after a left orchiectomy for an undescended left testicle. Pathologic examination identified a monodermal teratoma composed of thyroid parenchyma and associated with a 1.7-cm papillary thyroid carcinoma. Further evaluation showed a pulmonary mass on a chest CT scan. Total thyroidectomy revealed a 0.5-mm focus of papillary thyroid cancer, and removal of the lung mass confirmed metastatic papillary thyroid cancer. Array-comparative genomic hybridization of both tumors showed trisomy 17 in the struma testes and the lung metastasis. The patient responded well to radioactive iodine ablation and has no evidence of cancer 3 years later.

Conclusion: To our knowledge, this is the first case of papillary thyroid cancer in struma testes metastatic to the lung. It highlights the difficulties in treating these patients. Surgery to remove cancer foci, followed by radioactive iodine ablation, resulted in an excellent response in our patient. Interestingly, trisomy 17, which has so far been observed only in noninvasive thyroid nodules, was associated with pulmonary metastasis in our patient.

No MeSH data available.


Related in: MedlinePlus