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Cutaneous metastasis from Hürthle cell follicular thyroid carcinoma
Metástasis cutánea de carcinoma tiroideo folicular de células de Hürthle
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B) MIP e imágenes axiales de PET/TC con <span class="elsevierStyleSup">18</span>F-FDG en las que, además de una lesión hipermetabólica pulmonar (cabeza de flecha) se evidencia una lesión nodular de densidad partes blandas, de 30<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>36<span class="elsevierStyleHsp" style=""></span>mm, localizada en planos subcutáneos del flanco izquierdo (flecha) con alta actividad metabólica (SUVmáx: 77,45).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "F.J. García-Gómez, T. Cambil-Molina, T. Martín-Hernández, G. Sabatel-Hernández, M.C. Calvo-Morón, J. Castro-Montaño" "autores" => array:6 [ 0 => array:2 [ "nombre" => "F.J." "apellidos" => "García-Gómez" ] 1 => array:2 [ "nombre" => "T." "apellidos" => "Cambil-Molina" ] 2 => array:2 [ "nombre" => "T." "apellidos" => "Martín-Hernández" ] 3 => array:2 [ "nombre" => "G." "apellidos" => "Sabatel-Hernández" ] 4 => array:2 [ "nombre" => "M.C." 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Hallazgos en la PET/TC con <span class="elsevierStyleSup">18</span>F-FDG" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 684 "Ancho" => 1200 "Tamanyo" => 223915 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Hematoxylin and eosin staining (A) showed a tumor composed of myofibroblastic spindle cells accompanied by an inflammatory infiltrate,<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a> and a low mitotic activity (less than 1/10 HPF). On immunohistochemical analysis (B) the tumor cells were positive for desmin, smooth muscle actin, and anaplastic lymphoma kinase (ALK). The alteration of the ALK gene (CD246) have generally been reported to have no effect on prognosis, local recurrence, distant metastasis and overall survival, although some studies have detected a tendency to a better prognosis.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Alicia Díaz Silván, Ana Allende Riera, Dolores Cabello García, Olga Vilahomat Hernández, Eva Martínez Gimeno" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Alicia" "apellidos" => "Díaz Silván" ] 1 => array:2 [ "nombre" => "Ana" "apellidos" => "Allende Riera" ] 2 => array:2 [ "nombre" => "Dolores" "apellidos" => "Cabello García" ] 3 => array:2 [ "nombre" => "Olga" "apellidos" => "Vilahomat Hernández" ] 4 => array:2 [ "nombre" => "Eva" "apellidos" => "Martínez Gimeno" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S2253654X18300908" "doi" => "10.1016/j.remn.2018.06.004" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253654X18300908?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S225380891830051X?idApp=UINPBA00004N" "url" => "/22538089/0000003800000003/v1_201905020850/S225380891830051X/v1_201905020850/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2253808918300594" "issn" => "22538089" "doi" => "10.1016/j.remnie.2018.07.006" "estado" => "S300" "fechaPublicacion" => "2019-05-01" "aid" => "1005" "copyright" => "Sociedad Española de Medicina Nuclear e Imagen Molecular" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Rev Esp Med Nucl Imagen Mol. 2019;38:186-7" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 4 "formatos" => array:2 [ "HTML" => 2 "PDF" => 2 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Interesting images</span>" "titulo" => "Perigastric varices detected in a gastrointestinal bleeding study with <span class="elsevierStyleSup">99m</span>Tc-labeled red blood cells SPECT/CT" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "186" "paginaFinal" => "187" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Varices perigástricas detectadas en un estudio de hemorragia digestiva mediante SPECT/TC con hematíes marcados con <span class="elsevierStyleSup">99m</span>Tc" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1878 "Ancho" => 905 "Tamanyo" => 121742 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">SPECT/CT was performed at 1 hour after injection of <span class="elsevierStyleSup">99m</span>Tc-RBC. 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(B) MIP and axial slices of <span class="elsevierStyleSup">18</span>F-FDG PET/CT in which, in addition to a hypermetabolic pulmonary nodular lesion (arrow-head), a 30<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>36<span class="elsevierStyleHsp" style=""></span>mm soft tissue density nodular lesion (arrow) located subcutaneous on the left flank with high metabolic activity (SUVmax: 77.45) was observed.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Cutaneous metastasis of the thyroid cancer is very rare (less than 1% of cutaneous metastases) being more frequently associated with follicular thyroid carcinoma (42%). When it occurs, it can exhibit diverse cutaneous histomorphologies. In 70% of cases, cutaneous metastases are located on the scalp and the rest on the face or neck, due to the rich vascularization of the dermis in these locations,<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">1,2</span></a> being extremely rare in the abdomen. The development of these metastases is associated with involvement of other distant tissues and poor prognosis.</p><p id="par0010" class="elsevierStylePara elsevierViewall">We report a 69-year-old patient with history of Hürthle cell thyroid cancer studied by high levels of thyroglobuline (Tg-off: 153<span class="elsevierStyleHsp" style=""></span>mg/dl; Tg-on: 25.9<span class="elsevierStyleHsp" style=""></span>mg/dl) with negative CT and 131-iodine wholebody scans (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A). <span class="elsevierStyleSup">18</span>F-FDG PET/CT revealed pulmonary metastasis as well as a nodular left subcutaneous lesion on the left flank with high metabolic rate (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B, arrows). A piece of 360<span class="elsevierStyleHsp" style=""></span>g was resected, with pathology report of Hürthle cell follicular carcinoma which infiltrated adipose tissue, deep and superficial dermis without reaching epidermis. The surgical resection edges were tumor-free.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Despite the rarity of skin metastases from thyroid carcinoma, this possibility should be taken into consideration in the differential diagnosis of firm, painless and treatment-resistant skin metastases, as early diagnosis and treatment can improve prognosis.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">3</span></a></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0020" class="elsevierStylePara elsevierViewall">None.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: García-Gómez FJ, Cambil-Molina T, Martín-Hernández T, Sabatel-Hernández G, Calvo-Morón MdlC, Castro-Montaño J. Metástasis cutánea de carcinoma tiroideo folicular de células de Hürthle. Rev Esp Med Nucl Imagen Mol. 2019;38:188–189.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1012 "Ancho" => 1935 "Tamanyo" => 289296 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Anterior and posterior projections of 131-iodine wholebody scan without pathologic findings. (B) MIP and axial slices of <span class="elsevierStyleSup">18</span>F-FDG PET/CT in which, in addition to a hypermetabolic pulmonary nodular lesion (arrow-head), a 30<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>36<span class="elsevierStyleHsp" style=""></span>mm soft tissue density nodular lesion (arrow) located subcutaneous on the left flank with high metabolic activity (SUVmax: 77.45) was observed.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0020" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cutaneous metastases on the head and neck from a papillary thyroid carcinoma, follicular variant" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Márquez García" 1 => "L. Ferrándiz Pulido" 2 => "J.J. Ríos-Martín" 3 => "F.M. Camacho Martínez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Dermosifiliogr" "fecha" => "2016" "volumen" => "107" "paginaInicial" => "83" "paginaFinal" => "85" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0025" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Papillary and follicular thyroid carcinoma metastatic to the skin: a case report and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "E.A. Koller" 1 => "J.B. Tourtelot" 2 => "H.S. Pak" 3 => "M.W. Cobb" 4 => "J.C. Moad" 5 => "E.A. Flynn" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Thyroid" "fecha" => "1998" "volumen" => "8" "paginaInicial" => "1045" "paginaFinal" => "1050" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0030" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cutaneous metastasis from follicular carcinoma of the thyroid gland" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "P. Caron" 1 => "A. Moreau-Cabarrot" 2 => "B. Gorguet" 3 => "J. Bazex" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Thyroid" "fecha" => "1993" "volumen" => "3" "paginaInicial" => "235" "paginaFinal" => "237" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22538089/0000003800000003/v1_201905020850/S2253808918300776/v1_201905020850/en/main.assets" "Apartado" => array:4 [ "identificador" => "47121" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Interesting image" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22538089/0000003800000003/v1_201905020850/S2253808918300776/v1_201905020850/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808918300776?idApp=UINPBA00004N" ]
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