Journal of Gastrointestinal Cancer

, Volume 50, Issue 1, pp 9–15 | Cite as

Long-Term Outcomes After Hepatic and Pancreatic Resections for Metastases from Thyroid Cancer: a Systematic Review of the Literature

  • Anna Paspala
  • Ioannis D. Kostakis
  • Apostolos Gaitanidis
  • Anastasia Prodromidou
  • Dimitrios Schizas
  • Nikolaos MachairasEmail author
Review Article



The objective of our systematic review was to evaluate the long-term outcomes of surgical resection as a treatment strategy for liver and pancreatic metastases from thyroid cancer (TC).


A systematic search of three electronic databases for articles published up to October 2018 was conducted. All appropriate observational studies and case reports which reported outcomes from patients with TC metastatic to the liver or pancreas were considered eligible for inclusion in the present systematic review.


A total of 15 studies, which comprised of 16 patients that underwent hepatic or pancreatic resection for TC metastasis, were included in the present systematic review; among them, 5 presented with metastasis to the liver, whereas 11 had pancreatic metastatic disease. The median time interval between the initial thyroidectomy and the diagnosis of metastases (either hepatic or pancreatic) was 60 months (SE 23.8, 95% CI 13.3–106.7) for the entire cohort and the mean overall survival was 37.6 months (SE 8, 95% CI 22–53.3). Five patients with pancreatic metastases presented with recurrence whereas no recurrences were noted in patients with liver metastases.


Surgical resection of liver and pancreatic metastases from TC seems to be a safe and efficient treatment option for selected patients. In that setting, long-term outcomes in patients with resected TCLM are encouraging given the absence of recurrence as reported from the included studies, whereas in the case of TCPM, survival is limited due to advanced disease at diagnosis and recurrence rates.


Thyroid cancer Metastasis Liver Pancreas Survival 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.


  1. 1.
    Jones MK. Management of papillary and follicular thyroid cancer. J R Soc Med. 2002;95:325–6.CrossRefGoogle Scholar
  2. 2.
    Schlumberger MJ. Papillary and follicular thyroid carcinoma. N Engl J Med. 1998;338:297–306. Scholar
  3. 3.
    Haq M, Harmer C. Differentiated thyroid carcinoma with distant metastases at presentation: prognostic factors and outcome. Clin Endocrinol. 2005;63:87–93. Scholar
  4. 4.
    Hoie J, Stenwig AE, Kullmann G, Lindegaard M. Distant metastases in papillary thyroid cancer. A review of 91 patients. Cancer. 1988;61:1–6.CrossRefGoogle Scholar
  5. 5.
    Shaha AR, Shah JP, Loree TR. Differentiated thyroid cancer presenting initially with distant metastasis. Am J Surg. 1997;174:474–6.CrossRefGoogle Scholar
  6. 6.
    Ito Y, Miyauchi A. Prognostic factors and therapeutic strategies for differentiated carcinomas of the thyroid. Endocr J. 2009;56:177–92.CrossRefGoogle Scholar
  7. 7.
    Song HJ, Xue YL, Qiu ZL, Luo QY. Uncommon metastases from differentiated thyroid carcinoma. Hell J Nucl Med. 2012;15:233–40. Scholar
  8. 8.
    Sperti C, Moletta L, Patane G. Metastatic tumors to the pancreas: the role of surgery. World J Gastrointest Oncol. 2014;6:381–92. Scholar
  9. 9.
    Nakamura E, Shimizu M, Itoh T, Manabe T. Secondary tumors of the pancreas: clinicopathological study of 103 autopsy cases of Japanese patients. Pathol Int. 2001;51:686–90.CrossRefGoogle Scholar
  10. 10.
    Crippa S, Angelini C, Mussi C, Bonardi C, Romano F, Sartori P, et al. Surgical treatment of metastatic tumors to the pancreas: a single center experience and review of the literature. World J Surg. 2006;30:1536–42. Scholar
  11. 11.
    Wertenbroek MW, Links TP, Prins TR, Plukker JT, van der Jagt EJ, de Jong KP. Radiofrequency ablation of hepatic metastases from thyroid carcinoma. Thyroid. 2008;18:1105–10. Scholar
  12. 12.
    Segkos K, Schmidt C, Nabhan F. Isolated liver metastasis in Hurthle cell thyroid cancer treated with microwave ablation. Case Rep Endocrinol. 2017;2017(2790741):1–4. Scholar
  13. 13.
    Ibarrola de Andres C, Castellano Megias VM, Ballestin Carcavilla C, Alberti Masgrau N, Perez Barrios A, De Agustin PA. Hepatic metastases from the spindle cell variant of medullary thyroid carcinoma: report of a case with diagnosis by fine needle aspiration biopsy. Acta Cytol. 2001;45:1022–6. Scholar
  14. 14.
    Andreou A, Brouquet A, Bharathy KG, Perrier ND, Abdalla EK, Curley SA, et al. Liver resection for liver metastases from nondigestive endocrine cancer: extrahepatic disease burden defines outcome. Surgery. 2012;151:851–9. Scholar
  15. 15.
    Siddiqui AA, Olansky L, Sawh RN, Tierney WM. Pancreatic metastasis of tall cell variant of papillary thyroid carcinoma: diagnosis by endoscopic ultrasound-guided fine needle aspiration. JOP. 2006;7:417–22.Google Scholar
  16. 16.
    Meyer A, Behrend M. Is pancreatic resection justified for metastasis of papillary thyroid cancer? Anticancer Res. 2006;26:2269–73.Google Scholar
  17. 17.
    Djenic B, Duick D, Newell JO, Demeure MJ. Solitary liver metastasis from follicular variant papillary thyroid carcinoma: a case report and literature review. Int J Surg Case Rep. 2015;6C:146–9. Scholar
  18. 18.
    Zhou J, Luo Y, Ma BY, Ling WW, Zhu XL. Contrast-enhanced ultrasound diagnosis of hepatic metastasis of concurrent medullary-papillary thyroid carcinoma: a case report. Medicine. 2017;96:e9065. Scholar
  19. 19.
    Besic N, Schwarzbartl-Pevec A, Vidergar-Kralj B, Crnic T, Gazic B, Marolt Music M. Treatment and outcome of 32 patients with distant metastases of Hurthle cell thyroid carcinoma: a single-institution experience. BMC Cancer. 2016;16(162):162. Scholar
  20. 20.
    Salvatori M, Perotti G, Rufini V, Maussier ML, Summaria V, Fadda G, et al. Solitary liver metastasis from Hurthle cell thyroid cancer: a case report and review of the literature. J Endocrinol Investig. 2004;27:52–6. Scholar
  21. 21.
    Kouso H, Ikegami T, Ezaki T, Ishida T, Aimitsu S, Fujihara M, et al. Liver metastasis from thyroid carcinoma 32 years after resection of the primary tumor: report of a case. Surg Today. 2005;35:480–2. Scholar
  22. 22.
    Jobran R, Baloch ZW, Aviles V, Rosato EF, Schwartz S, LiVolsi VA. Tall cell papillary carcinoma of the thyroid: metastatic to the pancreas. Thyroid. 2000;10:185–7. Scholar
  23. 23.
    Angeles-Angeles A, Chable-Montero F, Martinez-Benitez B, Albores-Saavedra J. Unusual metastases of papillary thyroid carcinoma: report of 2 cases. Ann Diagn Pathol. 2009;13:189–96. Scholar
  24. 24.
    Niess H, Conrad C, Kleespies A, Haas F, Bao Q, Jauch KW, et al. Surgery for metastasis to the pancreas: is it safe and effective? J Surg Oncol. 2013;107:859–64. Scholar
  25. 25.
    Murakami Y, Shimura T, Okada R, Kofunato Y, Ishigame T, Yashima R, et al. Pancreatic metastasis of papillary thyroid carcinoma preoperatively diagnosed by endoscopic ultrasound-guided fine-needle aspiration biopsy: a case report with review of literatures. Clin J Gastroenterol. 2018;11:521–9. Scholar
  26. 26.
    Na HJ, Kim BH, Kim JR, Oh MY, Kim SM, Song BG, et al. FDG PET/CT in the detection of pancreatic metastasis in a patient with follicular thyroid carcinoma and negative I-131 whole body scan findings. Intern Med. 2014;53:2095–9.CrossRefGoogle Scholar
  27. 27.
    Li XO, Li ZP, Wang P, Li CL, Wu JH, Zhang JZ, et al. Pancreatic metastasis of papillary thyroid carcinoma: a case report with review of the literature. Int J Clin Exp Pathol. 2014;7:819–22.Google Scholar
  28. 28.
    Tunio MA, Alasiri M, Riaz K, Alshakweer W. Pancreas as delayed site of metastasis from papillary thyroid carcinoma. Case Rep Gastrointest Med. 2013;2013(386263):1–4. Scholar
  29. 29.
    Borschitz T, Eichhorn W, Fottner C, Hansen T, Schad A, Schadmand-Fischer S, et al. Diagnosis and treatment of pancreatic metastases of a papillary thyroid carcinoma. Thyroid. 2010;20:93–8. Scholar
  30. 30.
    Alzahrani AS, AlQaraawi A, Al Sohaibani F, Almanea H, Abalkhail H. Pancreatic metastasis arising from a BRAF(V600E)-positive papillary thyroid cancer: the role of endoscopic ultrasound-guided biopsy and response to sorafenib therapy. Thyroid. 2012;22:536–41. Scholar
  31. 31.
    Saito Y, Sugino K, Takami H, Matsuzu K, Uruno T, Ohkuwa K, et al. Clinical status and treatment of liver metastasis of differentiated thyroid cancer using tyrosine kinase inhibitors. World J Surg. 2018;42:3632–7. Scholar

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.3rd Department of SurgeryNational and Kapodistrian University of Athens, Attikon University HospitalChaidariGreece
  2. 2.1st Department of SurgeryMetaxa Memorial HospitalPiraeusGreece
  3. 3.1st Department of SurgeryNational and Kapodistrian University of Athens, Laiko General HospitalAthensGreece

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