May 30, 2010

Miliary Pulmonary Metastasis

Axial CT image shows multiple small 2-3 mm nodules (arrows) throughout both lungs in a patient with thyroid cancer.

Facts: Miliary Metastasis
  • Uncommon form of pulmonary metastasis
  • Most commonly due to thyroid cancer, renal cell carcinoma and melanoma
Pulmonary Metastasis in Thyroid Cancer
  • Distant metastasis (lung and bone) found in 10-15% of patients with differentiated thyroid cancer
  • Lung metastasis is most frequent in young patients with papillary carcinoma, and lungs are almost the only site of distant metastasis in children
  • Variables found to be adversely affected survival: extensive metastasis, older age at metastasis, absent I-131 uptake of metastasis, and moderately differentiated follicular cell carcinoma
Our case: thyroid cancer with miliary metastasis

References:
1. Biersack HJ, Grunwald F. Thyroid cancer, 2nd ed, 2005.
2. Schlumberger MJ. Papillary and follicular thyroid carcinoma. N Eng J Med 1998;338:297-306.

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