Thyroid metastases: a 45-year population-based descriptive study (1979-2024).

Abstract

Background: Metastases to the thyroid are rare but clinically important, as they may mimic primary thyroid malignancy and can be the first sign of recurrence of a prior solid tumor.

Methods: We conducted a retrospective descriptive population-based study using a thyroid cancer registry in northeastern France. All patients diagnosed with thyroid metastasis between 1975 and 2024 were identified; medical records and pathology reports were reviewed to confirm secondary origin and to collect demographic, clinical, pathological and treatment data. Thyroid metastases diagnosed within 6 months of the primary cancer were classified as synchronous; all others were considered metachronous. Overall survival was estimated from the dates of primary cancer diagnosis and of thyroid metastasis diagnosis using Kaplan-Meier methods and compared by primary tumor site using the log-rank test.

Results: Among the 3,647 thyroid tumors recorded between 1975 and 2024, 37 potential secondary thyroid tumors were identified; after medical record review, 8 cases were excluded (insufficient clinical data or uncertain histological origin), leaving 29 confirmed thyroid metastases. Mean age at thyroid metastasis diagnosis was 61.7 years (median 65; range 38-84), with slight male predominance (55.2%; sex ratio 1.23). Primary sites were kidney (24.1%), head and neck (20.7%), lung (17.2%) and lower gastrointestinal (13.8%). Metastases were metachronous in nearly half of the cases (48.3%). Thyroid surgery was performed in 62.1% of cases. Median survival was 5 years after initial diagnosis and 30 months after the diagnosis of thyroid metastasis. Renal cancers showed more favorable outcomes (120 vs 17 months' survival; log-rank, p=0.0037).

Conclusions: In this population-based series spanning 50 years, thyroid metastases were a rare but not exceptional clinical situation. They should be considered in the evaluation of thyroid nodules in patients with history of solid cancer. Renal primaries are associated with more favorable survival.