Innumerable Radioiodine Negative Cutaneous Metastases From Papillary Thyroid Cancer

Nishikant A. Damle, Soundararajan Ramya, Harmandeep Singh, Prashant Durgapal, Chandrasekhar Bal, Sandeep Mathur, Praveen Kumar


Differentiated thyroid cancer (DTC) is the most common endocrine malignancy and papillary thyroid carcinoma (PTC) accounts for a majority of these. Distant metastases, especially to the lung and bones, occur in about 10% of patients, who can still survive for many years. We report here the case of a 32 year old female who presented with multiple bilateral cervical lymphadenopathy, diagnosed as metastatic PTC on cytology. She underwent total thyroidectomy and bilateral radical neck dissection followed by radioiodine therapy. Subsequently she developed pulmonary and bone metastases, and during the course of successive radioiodine doses, presented with multiple, painless cutaneous and subcutaneous nodules which proved to be metastatic on cytopathology and immunostaining. Radioiodine uptake was not seen in these lesions, suggesting dedifferentiation of follicular cells. This case emphasizes three clinically important issues-firstly, although extremely rare, cutaneous nodules can represent metastatic PTC in patients with pre existing lung and bone lesions and portends a poorer prognosis. Secondly, these lesions may be dedifferentiated and hence not amenable to radioiodine therapy although the bone and lung lesions show radioiodine uptake. SPECT/CT helps us in determining if uptake of 131-I is in the skin lesions or underlying other sites. Redifferentiating agents may play a role in management of such disease. Lastly, immunostaining with CK19 and Thyroglobulin (Tg) can be highly useful to confirm the pathologic diagnosis.

J Endocrinol Metab. 2011;1(5):227-231


Cutaneous metastases; Papillary thyroid cancer; Radioiodine; SPECT/CT

Full Text: HTML PDF

Browse  Journals  


Journal of Clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics


World Journal of Oncology

Gastroenterology Research

Journal of Hematology


Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity


Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research


Journal of Neurology Research

International Journal of Clinical Pediatrics



Journal of Endocrinology and Metabolism, bimonthly, ISSN 1923-2861 (print), 1923-287X (online), published by Elmer Press Inc.                     
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)

This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website:   editorial contact:
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.

Disclaimer: The views and opinions expressed in the published articles are those of the authors and do not necessarily reflect the views or opinions of the editors and Elmer Press Inc. This website is provided for medical research and informational purposes only and does not constitute any medical advice or professional services. The information provided in this journal should not be used for diagnosis and treatment, those seeking medical advice should always consult with a licensed physician.