Varadarajan Varun V, Pace Elizabeth K, Patel Vatsal, Sawhney Raja, Amdur Robert J, Dziegielewski Peter T
Department of Otolaryngology (ENT), University of Florida, Gainesville, FL, 32610, USA.
University of Florida College of Medicine, Gainesville, FL, USA.
BMC Cancer. 2017 Mar 28;17(1):225. doi: 10.1186/s12885-017-3199-3.
Follicular thyroid carcinoma (FTC) metastasis to the facial skeleton is exceedingly rare. A case of FTC metastasizing to the mandible is presented and a systematic review of the literature describing thyroid metastasis to the facial skeleton is performed.
A 73-year-old female presented with metastatic FTC to the mandible and underwent total thyroidectomy, segmental mandibulectomy, bone impacted fibular free flap reconstruction, and adjuvant radioactive iodine treatment. The PubMed database was searched for literature describing thyroid cancer with facial skeleton metastasis using the key words "thyroid," "cancer," "carcinoma," "metastasis," and "malignancy" with "oral cavity," "maxilla," "mandible," "sinus," "paranasal," and "orbit." Reports that only involved the soft tissues were excluded. Systematic review revealed 59 cases of well-differentiated thyroid cancer with facial skeleton metastasis: 35 mandibular metastases (21 = FTC), 6 maxilla metastases (2 = FTC), 9 orbital metastases (4 = FTC), and 11 paranasal sinus metastases (7 = FTC). Treatment included surgery, RAI, external beam radiotherapy (XRT), or a combination of these modalities. The one, two, and five-year survival rates were 100%, 79%, and 16%, respectively.
Facial skeleton metastasis of FTC is a rare clinical challenge. Optimal treatment appears to include total thyroidectomy and resection of involved structures with or without adjuvant treatment.
滤泡性甲状腺癌（FTC）转移至面骨极为罕见。本文报告一例FTC转移至下颌骨的病例，并对描述甲状腺转移至面骨的文献进行系统综述。
一名73岁女性因FTC转移至下颌骨就诊，接受了全甲状腺切除术、下颌骨部分切除术、骨植入腓骨游离皮瓣重建术及辅助放射性碘治疗。使用关键词“甲状腺”“癌”“癌肿”“转移”“恶性肿瘤”以及“口腔”“上颌骨”“下颌骨”“鼻窦”“鼻旁”和“眼眶”在PubMed数据库中检索描述甲状腺癌伴面骨转移的文献。排除仅涉及软组织的报告。系统综述显示59例分化良好的甲状腺癌伴面骨转移：35例下颌骨转移（21例=FTC），6例上颌骨转移（2例=FTC），9例眼眶转移（4例=FTC），11例鼻旁窦转移（7例=FTC）。治疗方法包括手术、放射性碘治疗（RAI）、外照射放疗（XRT）或这些方法的联合应用。1年、2年和5年生存率分别为100%、79%和16%。
FTC的面骨转移是一项罕见的临床挑战。最佳治疗方案似乎包括全甲状腺切除术以及切除受累结构，可联合或不联合辅助治疗。
