Parotid metastasis as the first presentation of papillary thyroid carcinoma

Document Type : Case Report

Authors

1 Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

2 Department of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Cancer Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Parotid metastasis originated from papillary thyroid carcinoma is extremely rare, especially as the first presentation of the disease. We present a 70-year-old man with a history of painless swelling in the right side of the neck. He was evaluated for parotid tumor and histopathologic examination revealed a poorly differentiated carcinoma in the parotid gland with suspicion of thyroid origin. The thyroid was examined and a small nodule was palpable in the right lobe of the thyroid that was found to be dedifferentiated papillary thyroid carcinoma upon total thyroidectomy. He received 5.5GBq of 131I and post-ablation whole body iodine scan showed thyroid remnant, cervical lymph node metastasis, lung and pericardial metastases and pleural effusion. He succumbed to his disease 8 months after diagnosis despite further treatments efforts including chemoradiation.

Keywords

Main Subjects

References

  1. Venkatesh S, Srinivas T, Hariprasad S. Parotid gland tumors: 2-year prospective clinicopathological study. Ann Maxillofac Surg. 2019 Jan-Jun;9(1):103-109.
  2. Wu ZH, Ge MH, Cao J, Lan XB, Zhu XH, Huang YQ, Yu B. Parotid metastases from thyroid carcinomas. Int J Clin Exp Pathol. 2017 Oct 1;10(10):10467-10474.
  3. Kilic K, Sakat MS, Gozeler MS, Demirci E. Parotid gland involvement as an initial presentation of papillary thyroid carcinoma. Int J Oral Maxillofac Surg. 2017;46(8):965-7.
  4. Das R, Kumar M, Sharma J, Krishnatreya M, Chakraborty P, Kataki A. Papillary thyroid carcinoma presenting with mandibular metastasis: An unusual presentation. Clin Cancer Invest J. 2014;3(5):426-8.
  5. Shi X, Liu R, Basolo F, Giannini R, Shen X, Teng D, Guan H, Shan Z, Teng W1, Musholt TJ, Al-Kuraya K, Fugazzola L, Colombo C, Kebebew E, Jarzab B, Czarniecka A, Bendlova B, Sykorova V, Sobrinho-Simões M, Soares P, Shong YK, Kim TY, Cheng S, Asa SL, Viola D, Elisei R, Yip L, Mian C, Vianello F, Wang Y, Zhao S, Oler G, Cerutti JM, Puxeddu E, Qu S, Wei Q, Xu H, O'Neill CJ, Sywak MS, Clifton-Bligh R, Lam AK, Riesco-Eizaguirre G, Santisteban P, Yu H, Tallini G, Holt EH, Vasko V, Xing M. Differential clinicopathological risk and prognosis of major papillary thyroid cancer variants. J Clin Endocrinol Metab. 2016 Jan;101(1):264-74.
  6. Chen H, Luo D, Zhang L, Lin X, Luo Q, Yi H, Wang J, Yan X, Li B, Chen Y Liu X, Zhang H, Liu S1, Qiu M, Yang D, Jiang N. Restoration of p53 using the novel MDM2-p53 antagonist APG115 suppresses dedifferentiated papillary thyroid cancer cells. Oncotarget. 2017 Jun 27;8(26):43008-43022.
  7. Papp S, Asa SL. When thyroid carcinoma goes bad: a morphological and molecular analysis. Head Neck Pathol. 2015;9(1):16-23.
  8. Ibrahimpasic T, Ghossein R, Carlson DL, Nixon I, Palmer FL, Shaha AR, Patel SG, Tuttle RM, Shah JP, Ganly I. Outcomes in patients with poorly differentiated thyroid carcinoma. J Clin Endocrinol Metab. 2014 Apr;99(4):1245-52.
  9. Mathew PC, Balagopal PG, Thomas S, Sebastian P, Preethi TR. Parotid metastasis from carcinoma of the thyroid. Int J Oral Maxillofac Surg. 2007;36(10):965-6.
  10. Kini H, Pai RR, Kalpana S. Solitary parotid metastasis from columnar cell carcinoma of the thyroid: a diagnostic dilemma. Diagn Cytopathol. 2003;28(2):72-5.
  11. Gnepp D, Wenig B, Ellis G, Auclair P. Surgical pathology of the salivary glands. Major Probl Pathol. 1991;25:350-68.
  12. Thackray A. Tumors of the major salivary glands. Atlas of tumor pathology. Armed Forces Inst Pathol. 1974;10:14.
  13. Markitziu A, Fisher D, Marmary Y. Thyroid papillary carcinoma presenting as jaw and parotid gland metastases. Int J Oral Maxillofac Surg. 1986;15(5):648-53.
  14. Saikia B, Dey P, Saikia UN, Das A. Fine needle aspiration cytology of metastatic scalp nodules. Acta cytologica. 2001;45(4):537-41.
  15. Malhotra G, Nair N, Awasare S, Baghel NS. Metastatic parotid tumor: a rare presentation for papillary carcinoma of thyroid. Clin Nucl Med. 2007;32(6):488-90.
  16. Alzaraa A, Stone J, Williams G, Ahmed I, Quraishi M. Direct spread of thyroid follicular carcinoma to the parotid gland and the internal jugular vein: a case report. J Med Case Rep. 2008;2:297.
  17. Conway A, Wiernik A, Rawal A, Lam C, Mesa H. Occult primary medullary thyroid carcinoma presenting with pituitary and parotid metastases: case report and review of the literature. Endocr Pathol. 2012 Jun;23(2):115-22.
  18. Zilioli V, Peli A, Panarotto MB, Magri G, Alkraisheh A, Wiefels C, Rodella C, Giubbini R. Differentiated thyroid carcinoma: Incremental diagnostic value of I SPECT/CT over planar whole body scan after radioiodine therapy. Endocrine. 2017 Jun;56(3):551-559.

Files

Share

How to cite

Statistics