Unusual malignant thyroid tumours--a clinical study of 20 cases

The aim of this study is to assess late results of surgical treatment for primary non-Hodgkin lymphoma (PNHL), thyroid sarcomas (TS) and tumour metastases (TM) of the thyroid gland.

Between January 1st, 1990 and December 31st, 2005, 12725 patients were surgically treated for various types of goitre. Malignant tumour was diagnosed in 617 (4.9%) cases, consisting of 597 (96.8%) patients with thyroid carcinoma and 20 (3.2%) with other tumours, which included 9 (1.5%) cases of PNHL, 9 (1.5%) cases of TM and 2 (0.2%) patients who showed TS.

In the group of patients diagnosed with PNHL, variant B-cell lymphoma predominated (77.8%), and in cases of patients with TM renal cell carcinoma prevailed (77.8%). In all cases, hypo-echogenic nodules were observed in ultrasonography and cold nodules in scintigraphy. All patients were surgically treated with possible complementary chemotherapy and/or radiotherapy. At present, 5 patients with PNHL are alive--43-93 (average of 63.8) months after the operation. Others have died within a period of 2 days to 3 months after the operation. Two patients with TM are alive--19 and 46 (median 32.5) months after the operation. Others have died within a period of 3 to 62 (median 21) months after the operation. Patients with TS have died respectively 19 days and 13 months after the operation.

1. Patients with primary thyroid lymphomas should be approached individually using all available methods of treatment, including surgery and radiotherapy and/or chemotherapy. 2. Diagnosis of cold nodules in patients with oncological history should always arouse suspicion of metastases to the thyroid gland. 3. Diagnosis of non-thyroid cancer prior to surgery is difficult to obtain. 4. The need for surgery is usually based on local compression.