Table 1.
Clinicopathologic features of the patients with metastatic thyroid carcinoma and undetectable primary tumor: the study cohort and the reported cases in the literature.
| Clinical Features and outcome | Thyroid | Lymph node (LN) metastasis | BRAF V600 EIHC |
|||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age/ sex |
Presenting symptoms |
Post- operative |
Status (y)b |
Recurrence | Benign thyroid disease |
Fibros is in thyroid |
Positive LN/LN sampled (N) |
Size of largest metastatic focus/ largest involved LN (cm) |
LN cpt |
Histotype | ENE | |||
| TG (ng/ml) |
RAI/ RT |
|||||||||||||
| 1 | 49/F | Lateral neck mass with history of Hashimoto’s thyroiditis | NA | RAI | NED (17.0) | No | CLT | Multifocal a/w CLT | 5/11 | 1.9/2.0 | Lateral (pN1b) | PTC, classical | Absent | Positive a |
| 2 | 53/M | Bilateral thyroid nodules | <0.3 | None | NED (2.4) | No | NH | Multifocal a/w NH | 1/5 | 1.7/1.7 | Central (pN 1a) | PTC, classical | Absent | Positive |
| 3 | 55/M | Incidental pN1 detected on neck dissection for laryngeal SCC | <0.3 | RT for laryngeal SCC, No RAI | NED (2.2) | No | DQT, CCH | Multifocal a/w DQT | 2/65 | 0.66/0.85 | Lateral and central (pN1b) | PTC, follicular | Absent | Negative |
| 4 | 74/F | Thyroid nodule detected on US for hyperthyroidism | <0.3 | RAI | NED (0.8) | No | NH | Multifocal a/w NH | 2/36 | 0.05/0.15 | Central (pN1a) | PTC, follicular | Absent | Negative |
| 5 | 30/F | Grave's disease, post-methimazole treatment | <0.3 | None | NED (0.8) | No | CLT | Absent | 1/3 | 0.1/0.5 | Central (pN1a) | PTC, oncocytic solid | Absent | NA |
| 6 | 76/F | Lateral neck mass | <0.3 | RAI | DUC (3.7) | No | CLT, NH | Unifocal (0.2cm) | 1/13 | 4.5/4.5 | Lateral (pN1b) | PDTC | Present | Positive |
| 7 | 68/M | Lateral neck mass | NA | RT | AWD (1.9) | Yes, lung/spine | None | Absent | 6/86 | 5.5/5.5 | Lateral (pN1b) | ATC | Present | Positive c |
| Ref [4] | 29/F | lateral neck mass | NA | NA | NA | NA | NA | Present | NA | 1.5 | NA (pN1) | PTC classical | NA | NA |
| Ref [2] | 51/M | Bone metastasis | NA | NA | NA | NA | CLT | Present | NA | NA | Bone (pM1) | PTC | NA | NA |
Ref: reference, US: ultrasound, SCC: squamous cell carcinoma, CLT: chronic lymphocytic thyroiditis, NH: nodular hyperplasia; CCH: c cell hyperplasia; DQT: De Quervain thyroiditis; a/w: associated with; cpt: compartment, PDTC: poorly differentiated thyroid carcinoma; PTC: papillary thyroid carcinoma, ATC: anaplastic thyroid carcinoma, RAI: radioactive iodine, RT: radiation therapy, ENE: extranodal extension, NA: not available, DUC: dead of unknown cause, NED: no evidence of disease, AWD: alive with disease, IHC: immunohistochemistry.
A positive BRAF V600E immunostain was defined as strong (3+) homogenous immunolabeling in at least 60% of tumor cells.
At last follow-up (FU period, years).
BRAFV600E mutation also detected at the DNA level.