Abstract
Distant metastases from well-differentiated thyroid carcinoma typically involve the lungs and bones. We report a rare case of metastatic papillary thyroid carcinoma presenting as soft tissue lesion, detected by Iodine-131 whole-body scintigraphy in a 44-year-old asymptomatic male. The patient had previously undergone a total thyroidectomy and bilateral modified radical neck dissection, receiving radioiodine for pT3bN1bMx multifocal classical papillary thyroid carcinoma. Further evaluation with 18F-fluorodeoxyglucose positron emission tomography/computed tomography revealed additional sites of soft tissue and muscle metastasis, along with extensive nodal, lung, and skeletal involvement. These findings indicated advanced disease with a poor prognosis, necessitating a change in the treatment plan.
Keywords:
Iodine-131, thyroid cancer, 18F-fluorodeoxyglucose positron emission tomography/computed tomography, soft tissue metastasis, muscle metastasis
Ethics
Informed Consent: The patient provided written informed consent.
Authorship Contributions
Surgical and Medical Practices: M.F.M.R., S.Z.A.H., Concept: M.F.M.R., S.Z.A.H., Design: M.F.M.R., S.Z.A.H., Data Collection or Processing: M.F.M.R., S.Z.A.H., Analysis or Interpretation: M.F.M.R., S.Z.A.H., Literature Search: M.F.M.R., S.Z.A.H., Writing: M.F.M.R., S.Z.A.H.
Conflict of Interest: No conflicts of interest were declared by the authors.
Financial Disclosure: The authors declare that this study has received no financial support.
References
1Hitu L, Cainap C, Apostu D, Gabora K, Bonci EA, Badan M, Mester A, Piciu A. Skeletal muscle metastasis in papillary thyroid microcarcinoma evaluated by F18-FDG PET/CT. Diagnostics (Basel). 2020;10:100.
2Califano I, Quildrian S, Coduti M, Rojas Bilbao E, Otero J, Califano L. Soft tissue metastases from differentiated thyroid cancer diagnosed by 18 F FDG PET-CT. Arq Bras Endocrinol Metabol. 2013;57:317-321.
3Stephen J, Thomas MB, Thomas MB. A case of papillary thyroid cancer with soft tissue metastasis. Int Surg J. 2018;5:3425-3429.
4Qiu ZL, Luo QY. Erector spinae metastases from differentiated thyroid cancer identified by I-131 SPECT/CT. Clin Nucl Med. 2009;34:137-140.
5Ceriani L, Treglia G, Paone G, Bongiovanni M, Franscella S, Giovanella L. Unusual muscular metastases from papillary thyroid carcinoma detected by fluorine-18-fluorodeoxyglucose PET/MRI. J Clin Endocrinol Metab. 2013;98:2208-2209.
6Tunio MA, Alasiri M, Riaz K, Alshakwer W, Alarifi M. Skeletal muscle metastasis as an initial presentation of follicular thyroid carcinoma: a case report and a review of the literature. Case Rep Endocrinol. 2013;2013:192573. Epub 2013 Mar 28.
7Shin T, Hoang TD, Shane SP, Mai VQ, Shakir MKM. Multi‑focal metastatic papillary thyroid cancer to skeletal muscle with BRAFV600E mutation. Trends Med. 2020;20:2‑3.
8Sarma M, Sonik B, Subramanyam P, Sundaram PS. Isolated skeletal muscle metastatic deposit in a patient with micropapillary carcinoma thyroid identified by 18F FDG PET CT. J Egypt Natl Canc Inst. 2015;27:47-50.
9Herbowski L. Skeletal muscle metastases from papillary and follicular thyroid carcinomas: an extensive review of the literature. Oncol Lett. 2018;15:7083-7089.
10Stergioula A, Pantelis E, Kormas T, Agrogiannis G. Case report: skeletal muscle metastasis from follicular thyroid carcinoma presenting as synovial sarcoma. Front Oncol. 2023;13:994729.
