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Polish Society of
Endocrinology
Diagnosis, treatment, and prognosis in patients with liver metastases from follicular thyroid carcinoma (FTC)
07.02.2017
Małgorzata Kałużna, Monika Gołąb, Rafał Czepczyński, Grzegorz Dworacki, Danuta Bręborowicz, Marcin Orłowski, Katarzyna Katulska, Aleksandra Klimowicz, Maria Gryczyńska, Marek Ruchała, Katarzyna Ziemnicka
Abstract
Follicular thyroid carcinoma (FTC) is the second most common type of thyroid cancer (TC) and accounts for approximately 10% of all TC cases. Liver metastases are a rare presentation in 0.5–1% of follicular thyroid cancers, usually occurring in the setting of widely dissemi- nated FTC disease, and their presence is associated with poor prognosis. Until now, there have been only 30 cases of FTC liver metastases described in the literature. Herein, we review publications and describe diagnostic tools that may be used in the diagnosis and follow-up of FTC metastases to the liver, including biopsy and imaging techniques like US, CT, MRI, SPECT, PET, and radioiodine scintigraphy. We also present and discuss current methods of treatment, e.g. TSH suppressive therapy with levothyroxine, surgery, radiofrequency ablation (RFA), transarterial embolisation (TAE), liver transarterial chemoembolisation (TACE), chemotherapy with cisplatin and doxorubicin, treatment with Indium- 111-octreotide (or its analogues), and tyrosine kinase inhibitors (sorafenib, sunitinib). At the end we describe the course, results of diagnostics, and treatment in a patient with large multiple FTC metastases to the liver. (Endokrynol Pol 2016; 67 (3): 332–347)
Keywords: differentiated thyroid carcinoma (DTC); follicular thyroid cancer (FTC); liver metastases; positron emission tomography (PET); whole body scintigraphy (WBS)