Scalp metastases from thyroid carcinomas: review of clinical and pathological features

Abstract

Thyroid carcinomas reported to metastasize to scalp were reviewed and discussed with histopathological, prognostic and diagnostic aspects. All cases of scalp metastasis from thyroid carcinomas published in PubMed and MedLine were reviewed and the data of all patients were analyzed to obtain information about the patient demographics, histologic type of thyroid carcinoma, additional cutaneous sites, time interval between the diagnosis of the primary tumor and the diagnosis of scalp metastasis. The literature review revealed 38 cases of scalp metastasis from thyroid carcinoma. The most common histologic type was follicular carcinoma (46%), followed by papillary (35%), medullary (16%) and anaplastic carcinomas (3%). Scalp as a distinct cutaneous area has a rich dermal vasculature and is a site of various primary and metastatic neoplasms. Metastases to scalp from thyroid carcinomas are extremely rare and demonstrate advanced disease and poor prognosis. A scalp nodule may be a diagnostic challenge if it is the presenting symptom of an occult neoplasm with low metastatic potential. Awareness of the histopathological characteristics, and cutaneous metastatic patterns of thyroid carcinomas can help us to overcome the difficulty in diagnosis of such lesions.

Keywords

• Metastasis, scalp, thyroid carcinoma

Tiroid karsinomlarına bağlı skalp metastazları: Klinik ve patolojik özelliklerin incelenmesi

Öz

Bu derlemede literatürde skalp metastazı yaptığı bildirilen tiroid karsinom vakaları taranarak tanısal, histopatolojik ve prognostik özellikleri ile tartışıldı. PubMed ve MedLine servislerinde yayınlanan tüm tiroid karsinomlarına bağlı skalp metastazı vakaları araştırıldı ve hastaların yaş ve cinsiyetine, tiroid karsinomunun histolojik tipine, skalp dışında cilt alanlarına metastazlarına ve primer tümörün teşhisiyle metastaz teşhisi arasındaki süreye ilişkin verilere ulaşmak için hasta bilgileri incelendi. Literatürde günümüze kadar bildirilen 38 vaka bulundu. Bildirilen vakalarda en sık görülen histolojik tip foliküler karsinom (%46) idi. Papiller karsinom, medüller karsinom ve anaplastik karsinom vakalarının oranları ise sırasıyla %35, %16 ve %3 olarak bulundu. Özel bir cilt alanı olan skalp zengin bir damar ağına ve kanlanmaya sahip olup çeşitli primer veya metastatik tümörlerin odağı olabilir. Tiroid karsinomlarına bağlı skalp metastazları oldukça nadir olup ilerlemiş hastalığa ve kötü prognoza işaret eder. Düşük metastatik potansiyele sahip gizli bir neoplazmın ilk belirtisi olarak çıkabilen bir skalp nodülünün teşhisi oldukça güç olabilir. Tiroid karsinomlarının histopatolojik özelliklerinin ve cilt metastazı kalıplarının bilinmesiyle bu gibi lezyonların tanısına daha kolay ulaşılabilir.

Anahtar Kelimeler

• Metastaz, skalp, tiroid karsinomu

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36. Please cite this article as: Arslan S, Arslan E. Scalp metastases from thyroid carcinomas: review of clinical and pathological features. J Med Updates 2014;4(2):71-76.