Clinicopathological features and outcomes of rare lung adenocarcinoma metastasis to the thyroid gland: A single‐center, 11‐year experience

Abstract Background Metastasis to the thyroid gland from lung adenocarcinoma is rare and challenging to diagnose due to similar histopathological features. This study aimed to analyze the clinicopathological characteristics of and treatment strategies for lung adenocarcinoma metastasis to the thyroi...

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Main Authors: Xuehan Gao, Zhen Cao, Xiayao Diao, Jiaqi Zhang, Ke Zhao, Libing Yang, Zhihong Qian, Xiaoyun Zhou, Chao Guo, Yeye Chen, Ziwen Liu, Shanqing Li
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Thoracic Cancer
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Online Access:https://doi.org/10.1111/1759-7714.15486
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author Xuehan Gao
Zhen Cao
Xiayao Diao
Jiaqi Zhang
Ke Zhao
Libing Yang
Zhihong Qian
Xiaoyun Zhou
Chao Guo
Yeye Chen
Ziwen Liu
Shanqing Li
author_facet Xuehan Gao
Zhen Cao
Xiayao Diao
Jiaqi Zhang
Ke Zhao
Libing Yang
Zhihong Qian
Xiaoyun Zhou
Chao Guo
Yeye Chen
Ziwen Liu
Shanqing Li
author_sort Xuehan Gao
collection DOAJ
description Abstract Background Metastasis to the thyroid gland from lung adenocarcinoma is rare and challenging to diagnose due to similar histopathological features. This study aimed to analyze the clinicopathological characteristics of and treatment strategies for lung adenocarcinoma metastasis to the thyroid based on 11 years of institutional experience. Methods A retrospective study included patients with lung adenocarcinoma metastasis to the thyroid at our center from 2010 to 2023. Clinicopathological features and clinical outcomes were analyzed. Results Among 9714 lung adenocarcinoma patients, nine patients (five females, 55.6%) were diagnosed with thyroid metastasis, presenting primarily with cough symptoms. Most patients (88.9%) had synchronous tumors, whereas a minority (11.1%) had metachronous tumors. The median time from primary tumor diagnosis to metastasis was 4.8 months. Most patients developed bilateral thyroid metastases (88.9%). Diagnosis of thyroid metastasis was primarily through fine‐needle aspiration (FNA), with one case misdiagnosed as papillary thyroid carcinoma. Immunohistochemical staining revealed thyroid transcription factor‐1 (TTF‐1) and novel aspartic proteinase of pepsin family A (Napsin‐A) positivity and paired box 8 (PAX8) negativity. Genetic testing found epidermal growth factor receptor mutations in 71.4% of patients. The individualized comprehensive therapy included surgery, chemotherapy, immunotherapy, and targeted and supportive therapy. The median overall survival was 56.0 months, with a progression‐free survival of 12.7 months. Kaplan–Meier (K–M) analysis suggested improved survival with no advanced symptoms (p = 0.03) and targeted therapies (p = 0.05). Conclusions Lung adenocarcinoma metastasis to the thyroid is a rare disease, with an incidence of 0.1% among lung adenocarcinoma patients. Early treatment after symptom onset and personalized targeted therapies may improve prognosis. Despite rapid disease progression, favorable outcomes can be achieved with comprehensive treatment.
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spelling doaj-art-d4f2ac8df9d04cbe907c444350dd8d222025-01-15T16:00:32ZengWileyThoracic Cancer1759-77061759-77142025-01-01161n/an/a10.1111/1759-7714.15486Clinicopathological features and outcomes of rare lung adenocarcinoma metastasis to the thyroid gland: A single‐center, 11‐year experienceXuehan Gao0Zhen Cao1Xiayao Diao2Jiaqi Zhang3Ke Zhao4Libing Yang5Zhihong Qian6Xiaoyun Zhou7Chao Guo8Yeye Chen9Ziwen Liu10Shanqing Li11Department of Thoracic Surgery Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of General Surgery Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Thoracic Surgery Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Thoracic Surgery Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Thoracic Surgery Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Thoracic Surgery Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Basic Medical Sciences Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Thoracic Surgery Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Thoracic Surgery Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Thoracic Surgery Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of General Surgery Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Thoracic Surgery Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaAbstract Background Metastasis to the thyroid gland from lung adenocarcinoma is rare and challenging to diagnose due to similar histopathological features. This study aimed to analyze the clinicopathological characteristics of and treatment strategies for lung adenocarcinoma metastasis to the thyroid based on 11 years of institutional experience. Methods A retrospective study included patients with lung adenocarcinoma metastasis to the thyroid at our center from 2010 to 2023. Clinicopathological features and clinical outcomes were analyzed. Results Among 9714 lung adenocarcinoma patients, nine patients (five females, 55.6%) were diagnosed with thyroid metastasis, presenting primarily with cough symptoms. Most patients (88.9%) had synchronous tumors, whereas a minority (11.1%) had metachronous tumors. The median time from primary tumor diagnosis to metastasis was 4.8 months. Most patients developed bilateral thyroid metastases (88.9%). Diagnosis of thyroid metastasis was primarily through fine‐needle aspiration (FNA), with one case misdiagnosed as papillary thyroid carcinoma. Immunohistochemical staining revealed thyroid transcription factor‐1 (TTF‐1) and novel aspartic proteinase of pepsin family A (Napsin‐A) positivity and paired box 8 (PAX8) negativity. Genetic testing found epidermal growth factor receptor mutations in 71.4% of patients. The individualized comprehensive therapy included surgery, chemotherapy, immunotherapy, and targeted and supportive therapy. The median overall survival was 56.0 months, with a progression‐free survival of 12.7 months. Kaplan–Meier (K–M) analysis suggested improved survival with no advanced symptoms (p = 0.03) and targeted therapies (p = 0.05). Conclusions Lung adenocarcinoma metastasis to the thyroid is a rare disease, with an incidence of 0.1% among lung adenocarcinoma patients. Early treatment after symptom onset and personalized targeted therapies may improve prognosis. Despite rapid disease progression, favorable outcomes can be achieved with comprehensive treatment.https://doi.org/10.1111/1759-7714.15486lung adenocarcinomametastasisoutcomespathologythyroid
spellingShingle Xuehan Gao
Zhen Cao
Xiayao Diao
Jiaqi Zhang
Ke Zhao
Libing Yang
Zhihong Qian
Xiaoyun Zhou
Chao Guo
Yeye Chen
Ziwen Liu
Shanqing Li
Clinicopathological features and outcomes of rare lung adenocarcinoma metastasis to the thyroid gland: A single‐center, 11‐year experience
Thoracic Cancer
lung adenocarcinoma
metastasis
outcomes
pathology
thyroid
title Clinicopathological features and outcomes of rare lung adenocarcinoma metastasis to the thyroid gland: A single‐center, 11‐year experience
title_full Clinicopathological features and outcomes of rare lung adenocarcinoma metastasis to the thyroid gland: A single‐center, 11‐year experience
title_fullStr Clinicopathological features and outcomes of rare lung adenocarcinoma metastasis to the thyroid gland: A single‐center, 11‐year experience
title_full_unstemmed Clinicopathological features and outcomes of rare lung adenocarcinoma metastasis to the thyroid gland: A single‐center, 11‐year experience
title_short Clinicopathological features and outcomes of rare lung adenocarcinoma metastasis to the thyroid gland: A single‐center, 11‐year experience
title_sort clinicopathological features and outcomes of rare lung adenocarcinoma metastasis to the thyroid gland a single center 11 year experience
topic lung adenocarcinoma
metastasis
outcomes
pathology
thyroid
url https://doi.org/10.1111/1759-7714.15486
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