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Cholestatic syndrome as initial manifestation of pancreatic metastasis of papillary thyroid carcinoma: case report and review

Mariana Yoshii Tramontin, Paulo Antônio Silvestre de Faria, Cristina Moreira do Nascimento, Cibele de Aquino Barbosa, Maria de Fátima Rei Pereira Barros, Aniela Rodrigues Gomes de Barros, Rafaela Cardoso de Carvalho, Antônio Kneipp Pitta de Castro, Fernanda Accioly de Andrade, Rossana Corbo, Fernanda Vaisman, Daniel Bulzico
2020 Archives of Endocrinology and Metabolism  

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Most papillary thyroid carcinomas (PTC) harbor excellent prognosis. Although rare, distant metastases normally occur in lungs and/or bones. Here we describe a rare case of pancreatic metastasis presenting with rapid onset cholestatic syndrome. A literature review was also performed. A 73-year-old man with a high risk PTC was submitted to total thyroidectomy (TT) followed by radioiodine therapy. After initial therapy, he persisted with progressive rising serum thyroglobulin levels but with no
more » ... dence of structural disease. Recently, the patient presented with a rapid onset and progressive cholestatic syndrome. A 4 cm lesion in pancreas was identified, with echoendoscopy fine-needle aspiration biopsy (FNAB) confirming a pancreatic metastasis from PTC. The patient was submitted to a successful pancreaticoduodenectomy. Pancreatic metastases of PTC are rare and few long-term follow-up data are available to guide management. Fourteen cases were former reported, mean age was 65.7 years-old with mean time between PTC and pancreatic metastasis diagnosis of 7.9 years. Nine of them had another distant metastasis, nine were diagnosed by FNAB and just two received sorafenib.
doi:10.20945/2359-3997000000215 pmid:32236313 fatcat:dtbinhuaufejdmyc6gpnathske
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Mariana Yoshii Tramontin, Paulo Antônio Silvestre de Faria, Cristina Moreira do Nascimento, Cibele de Aquino Barbosa, Maria de Fátima Rei Pereira Barros, Aniela Rodrigues Gomes de Barros, Rafaela Cardoso de Carvalho, Antônio Kneipp Pitta de Castro, Fernanda Accioly de Andrade, Rossana Corbo, Fernanda Vaisman, Daniel Bulzico. "Cholestatic syndrome as initial manifestation of pancreatic metastasis of papillary thyroid carcinoma: case report and review." Archives of Endocrinology and Metabolism (2020)