The online version of this article (doi:10.1186/1752-1947-8-460) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
TA and MS analyzed and interpreted the patient’s clinical data and autopsy report and were major contributors to the writing of the manuscript. KS, NS, SO and MN contributed not only to the treatment of the patient but also to the analysis and interpretation of the case. YM performed pathological analysis of the case before the autopsy and interpreted the pathological findings. MM, MT and ST performed the autopsy of the case and interpreted the pathological findings. All authors read and approved the final manuscript.
Anaplastic transformation of well-differentiated papillary thyroid carcinoma at distant metastasis sites is rare. To the best of our knowledge, this is the first report of an autopsy case of anaplastic transformation of papillary thyroid carcinoma in multiple lung metastases presenting with a malignant pleural effusion.
We report an autopsy case of a 61-year-old Japanese man with anaplastic transformation of papillary thyroid carcinoma with multiple lung metastases presenting with a malignant pleural effusion, which was difficult to diagnose by cytological examination before the autopsy. He presented with a 1-month history of progressive dyspnea, and examination of the left pleural effusion revealed a bloody exudate with an increase in thyroglobulin; however, malignant cells in the pleural fluid were negative for thyroglobulin.
It is important to be aware that anaplastic transformation of differentiated thyroid carcinoma could develop in lung metastases and could be a cause of a malignant pleural effusion.
Patel KN, Shaha AR: Poorly differentiated and anaplastic thyroid cancer. Cancer Control. 2006, 13: 119-128. PubMed
Wiseman SM, Loree TR, Rigual NR, Hicks WL, Douglas WG, Anderson GR, Stoler DL: Anaplastic transformation of thyroid cancer: review of clinical, pathologic, and molecular evidence provides new insights into disease biology and future therapy. Head Neck. 2003, 25: 662-670. 10.1002/hed.10277. CrossRefPubMed
Sotome K, Onishi T, Hirano A, Nakamaru M, Furukawa A, Miyazaki H, Morozumi K, Tanaka Y, Iri H, Mimura Y: A rare case of anaplastic transformation within the metastatic site of the retroperitoneal region in a patient 17 years after total thyroidectomy for papillary carcinoma of the thyroid beginning with multiple bone metastases. Thyroid. 2007, 17: 1309-1311. 10.1089/thy.2006.0322. CrossRefPubMed
Takeshita Y, Takamura T, Minato H, Misu H, Ando H, Yamashita T, Ikeda H, Nakanuma Y, Kaneko S: Transformation of p53-positive papillary thyroid carcinoma to anaplastic carcinoma of the liver following postoperative radioactive iodine-131 therapy. Intern Med. 2008, 47: 1709-1712. 10.2169/internalmedicine.47.1190. CrossRefPubMed
Kaushal S, Sharma MC, Mathur SR, Rastogi S, Bal CS, Chumber S: Anaplastic transformation of metastatic papillary thyroid carcinoma at shoulder mimicking soft tissue sarcoma. Indian J Pathol Microbiol. 2011, 54: 796-799. PubMed
Shingu K, Kobayashi S, Yokoyama S, Fujimori M, Asanuma K, Ito KI, Hama Y, Maruyama M, Kusama R, Amano J: The likely transformation of papillary thyroid carcinoma into anaplastic carcinoma during postoperative radioactive iodine-131 therapy: report of a case. Surg Today. 2000, 30: 910-913. 10.1007/s005950070043. CrossRefPubMed
Sera N, Ashizawa K, Ando T, Ide A, Abe Y, Usa T, Tominaga T, Ejima E, Hayashi T, Shimokawa I, Eguchi K: Anaplastic changes associated with p53 gene mutation in differentiated thyroid carcinoma after insufficient radioactive iodine ( 131I) therapy. Thyroid. 2000, 10: 975-979. 10.1089/thy.2000.10.975. CrossRefPubMed
- Anaplastic transformation of papillary thyroid carcinoma in multiple lung metastases presenting with a malignant pleural effusion: a case report
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