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Late Pancreatic Metastasis From Papillary Thyroid Carcinoma Diagnosed by Endoscopic Ultrasound-Guided Tissue Acquisition

Year: 2025

Type: article

Abstract: Background: Papillary thyroid carcinoma, the most common differentiated thyroid cancer, has an indolent clinical course and a good prognosis. Metastases to the gastrointestinal tract account for <1% of all distant metastases, and the pancreas is an extremely rare site for metastasis from thyroid cancer. Case Report: We report the case of a patient who developed a pancreatic metastasis from a classic variant papillary thyroid carcinoma 11 years after total thyroidectomy, cervical lymphadenectomy, and radioactive iodine ablation. The patient experienced increased thyroglobulin levels, and abdominal computed tomography scan revealed a lesion in the uncinate process of the pancreas. Tissue samples obtained by endoscopic ultrasound-guided biopsy were positive for thyroglobulin and thyroid transcription factor 1. Because the patient was not a candidate for surgery, the metastatic lesion was not iodine-avid, and tyrosine kinase inhibitors could not be offered because of tumor-related symptoms, the patient was treated with stereotactic body radiotherapy only. The patient died almost 2 years after the diagnosis of metastatic papillary thyroid carcinoma to the pancreas (13 years after total thyroidectomy for the primary cancer). Conclusion: If pancreatic lesions are discovered during regular follow-up of patients who have previously been treated for papillary thyroid carcinoma, pancreatic metastasis must be considered, and imaging procedures other than whole-body iodine scintigraphy are required. Histopathology and iodine avidity will define the best therapeutic strategy. Radioactive iodine ablation should be considered for iodine-avid metastases, and surgery or tyrosine kinase inhibitors are promising options for non-iodine-avid lesions.

Source: Ochsner Journal

DOI: 10.31486/toj.24.0115

Authors: César Vivian Lopes, Júlia Fernanda Semmelmann Pereira-Lima, Marianna Lins de Souza Salerno, Felipe Luzzatto

Institutions: Santa Casa Hospital, Universidade Federal de Ciências da Saúde de Porto Alegre

Language: English

Topic: Thyroid Cancer Diagnosis and Treatment

Subfield: Endocrinology, Diabetes and Metabolism

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4409245863