Background

Despite its rich vasculature, the thyroid gland is a rare site of metastatic disease. We present a systematic review of colorectal cancer (CRC) thyroid metastases, with emphasis on diagnosis, therapeutic management, and oncological outcomes.

Methods

A systematic review of the English literature (1990 to 2019) was performed, using the PubMed, Embase, and Google Scholar bibliographic databases. For each patient, epidemiological, surgical, histopathological, and oncological data were extracted.

Results

A total of 111 patients (40% males, mean age 61 ± 12 years) were included in the final analysis. The primary CRC was locally advanced (T3-T4) in 83%, had positive lymph nodes (N+) in 65%, and had distant metastases (M+) in 28%. Thyroid metastases were synchronous in 15% and metachronous in 80%, with a mean interval of 51 ± 31 months from primary tumor treatment. Thyroid metastatic disease was diagnosed clinically (60%), radiologically (33%), biochemically (2%), or postmortem (5%). When performed, FNA biopsy was diagnostic in 73% and highly suspicious in 13%. A total of 63% of patients had additional distant metastases, usually in the liver or lungs, while 68% of patients underwent surgical excision (total or subtotal thyroidectomy 58%, lobectomy 42%) and 43% received adjuvant chemotherapy or radiotherapy. Mean overall survival after primary CRC was 55.5 ± 34.7 months, with mean disease-free survival of 31.3 ± 27.2 months. Following diagnosis or treatment of thyroid metastases, 1-, 2- and 3-year survival rates were 79, 66, and 60%, respectively. Mean survival following diagnosis of thyroid metastases was 11.3 months.

Conclusions

CRC thyroid metastasis is a relatively uncommon event, usually associated with locoregionally advanced tumors. Prognosis is poor, mainly due to multimetastatic disease.

中文翻译：

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结直肠癌甲状腺转移——系统评价

背景

尽管有丰富的脉管系统，甲状腺是转移性疾病的罕见部位。我们对结直肠癌 (CRC) 甲状腺转移进行了系统评价，重点是诊断、治疗管理和肿瘤学结果。

方法

使用 PubMed、Embase 和 Google Scholar 书目数据库对英语文献（1990 年至 2019 年）进行了系统回顾。对于每名患者，提取流行病学、外科、组织病理学和肿瘤学数据。

结果

最终分析共纳入 111 名患者（40% 为男性，平均年龄 61 ± 12 岁）。83% 的原发性 CRC 为局部晚期 (T3-T4)，65% 的淋巴结阳性 (N+)，28% 的远处转移 (M+)。15% 的甲状腺转移是同步的，80% 是异时的，与原发肿瘤治疗的平均间隔为 51 ± 31 个月。通过临床 (60%)、放射学 (33%)、生化 (2%) 或尸检 (5%) 诊断出甲状腺转移性疾病。进行时，细针穿刺活检诊断为 73%，高度可疑为 13%。共有 63% 的患者有额外的远处转移，通常在肝脏或肺部，而 68% 的患者接受了手术切除（甲状腺全切除术或次全切除术 58%，肺叶切除术 42%），43% 接受了辅助化疗或放疗。原发性 CRC 后的平均总生存期为 55.5 ± 34.7 个月，平均无病生存期为 31.3 ± 27.2 个月。诊断或治疗甲状腺转移后，1、2 和 3 年生存率分别为 79%、66% 和 60%。甲状腺转移诊断后的平均生存期为 11.3 个月。

结论

CRC 甲状腺转移是一种相对少见的事件，通常与局部晚期肿瘤相关。预后差，主要是由于多转移性疾病。