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

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

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

AUTOR(ES)

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

FONTE

Arch. Endocrinol. Metab.

DATA DE PUBLICAÇÃO

2020-04

RESUMO

SUMMARY 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 evidence 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.