Ultrasonographic Classification of the Metastases to the Thyroid Gland / 대한갑상선학회지

ABSTRACT

BACKGROUND AND OBJECTIVES: To classify the metastases to the thyroid gland arising from non-thyroidal malignancies on ultrasound (US). MATERIALS AND METHODS: We enrolled 45 consecutive patients with metastases to the thyroid gland from 2005 to 2012. We classified metastases into 4 types; type I diffuse non-mass forming lesion, type II a solitary suspicious nodule, type III multiple suspicious nodules, and type IV nodule(s) with no suspicion. We subcategorized type I into two subtypes; type IA diffusely infiltrative lesion, type IB diffuse micronodulation. RESULTS: The most frequent primary malignancy of thyroid metastases was lung cancer. The patients with thyroid metastases were 26 (57.8%) in type I; type IA 16 (35.6%), type IB 10 (22.2%), 14 (31.1%) in type II, 3 (6.7%) in type III and 2 (4.4%) in type IV. Type I metastasis included 18 of 25 patients with lung cancer and all 3 patients with stomach cancer. Thirty patients (73.3%) having type IA, II or III revealed malignant findings on US, in contrast, 12 (26.7%) patients having type IB or IV revealed no suspicious findings. CONCLUSION: Type I (diffuse non-mass forming lesion) was the most common in thyroid metastases. A quarter of thyroid metastases revealed no suspicious findings on US. Thyroid metastases can be considered as a differential diagnosis, when diffuse non-mass forming lesions or nodules with no suspicion are revealed on thyroid US.