Metastatic leiomyosarcoma of the thyroid gland: cytologic findings and differential diagnosis

Metastatic leiomyosarcoma to the thyroid is an extremely rare occurrence, and only 18 cases have been reported. Here, we report a case of a 37-year-old woman who presented with multiple masses on the scalp. Excisional biopsy was done and the mass revealed fascicles of smooth muscle fibers which showed positive staining for smooth muscle actin, thus confirming the diagnosis of leiomyosarcoma. The patient was also found to have a 0.9 cm mass within the left thyroid. Fine-needle aspiration was done and the cytological smear showed hypercellular spindle cell clusters with hyperchromatic and large nuclei. Normal thyroid follicular cells were found within or around tumor cells. In this report, we present the cytologic findings of metastatic leiomyosarcoma to the thyroid and offer differential diagnoses of the aspirated spindle cells.

[1]  O. Kuryk,et al.  Thyroid metastasis of vaginal leiomyosarcoma: a case report and review of the literature. , 2020, Experimental oncology.

[2]  Alex González-Bóssolo,et al.  A Rare Case of Uterine Leiomyosarcoma with Metastasis to the Thyroid Gland , 2020, Case reports in endocrinology.

[3]  J. Alberini,et al.  Uterine leiomyosarcoma metastatic to thyroid shown by 18F-FDG PET/CT imaging. , 2017, Revista espanola de medicina nuclear e imagen molecular.

[4]  R. Nayar,et al.  Metastatic Malignant Peripheral Nerve Sheath Tumor To the Thyroid , 2015 .

[5]  N. Yaqoob,et al.  Leiomyosarcoma metastatic to the thyroid diagnosed by fine needle aspiration cytology. , 2010, JPMA. The Journal of the Pakistan Medical Association.

[6]  M. Vankalakunti,et al.  Cytology of Sarcoma Metastasizing to the Thyroid , 2008, Acta Cytologica.

[7]  E. Genden,et al.  Metastasis of uterine leiomyosarcoma to the thyroid gland: case report and review of the literature. , 2007, Thyroid : official journal of the American Thyroid Association.

[8]  G. Tong,et al.  Fine‐needle aspiration biopsy of monophasic variant of spindle epithelial tumor with thymus‐like differentiation of the thyroid: Report of one case and review of the literature , 2007, Diagnostic cytopathology.

[9]  V. Livolsi,et al.  Primary spindle cell lesions of the thyroid gland; an overview. , 2006, American journal of clinical pathology.

[10]  Gang Wang,et al.  Metastasis of leiomyosarcoma to the thyroid. , 2005, Chinese medical journal.

[11]  L. Guidi,et al.  Pulmonary artery leiomyosarcoma with thyroid metastases. , 2003, Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace.

[12]  M. Conner,et al.  Uterine Leiomyosarcoma Metastatic to the Thyroid , 2002, Obstetrics and gynecology.

[13]  R. Udelsman,et al.  Clinically Significant, Isolated Metastatic Disease to the Thyroid Gland , 1999, World Journal of Surgery.

[14]  W. Lui,et al.  Metastatic leiomyosarcoma of the thyroid: a case report. , 1998, Zhonghua yi xue za zhi = Chinese medical journal; Free China ed.

[15]  P. Michelow,et al.  Metastases to the thyroid gland: Diagnosis by aspiration cytology , 1995, Diagnostic cytopathology.

[16]  M. Pfaltz,et al.  [Leiomyosarcoma in the thyroid gland--primary tumor or metastasis?]. , 1994, Der Pathologe.

[17]  P. Gattuso,et al.  Fine needle aspiration cytology of metastatic sarcoma involving the thyroid. , 1989, Southern medical journal.

[18]  J. H. Fisher,et al.  Leiomyosarcoma of the Saphenous Vein. , 1960, Canadian Medical Association journal.

[19]  K. Woo Young,et al.  Pulmonary leiomyosarcoma metastatic to the thyroid gland: case report and review of the literature. , 2011, Annales d'endocrinologie.

[20]  G. Samonis,et al.  Metastatic uterine leiomyosarcoma coexisting with papillary carcinoma of the thyroid gland , 2004, International Journal of Gynecologic Cancer.