Usefulness for Diagnosis and Management of Metastatic Carcinoma to the Thyroid

\s=b\The usefulness of fine-needle aspiration (FNA) for the diagnosis and management of metastatic carcinoma to the thyroid was determined by reviewing the records of 19 patients identified during a six-year period. Fine-needle aspiration was able to document metastatic cancer to the thyroid in 14 patients with, and five patients without a history of prior nonthyroidal cancer. Breast, kidney, and lung were the most frequent carcinomas metastatic to the thyroid. Age range and time from diagnosis of the primary carcinoma to documentation of metastasis were similar to those in prior surgical series from this institution. The finding of metastatic disease on FNA was totally unexpected in four patients. The possibility of metastasis was not mentioned before FNA in six patients with a known history of nonthyroidal cancer. Only six patients underwent a thyroid operation after FNA. Fine-needle aspiration was able to direct appropriate surgical or conservative management without adversely affecting survival among patients. (Arch Intern Med 1987;147:311-312) nphe use of fine-needle aspiration (FNA) to diagnose * metastatic cancer to the thyroid has been reported in several series. It has been used and advocated to confirm a clinical diagnosis of metastatic disease without operation, and also to determine preoperatively the nature of thyroid nodules in persons with known nonthyroidal cancers." Kini et al5 reported 20 cases of metastatic carcinoma to the thyroid diagnosed by FNA during a 5V2-year period. A survey of Mayo Clinic (Rochester, Minn) records from 1980 through 1985 documented 19 patients with metastatic carcinoma to the thyroid diagnosed by FNA. Their clinical presentation, type of metastatic cancer, and outcome are described, and comparisons are made with previous au¬ topsy and surgical series. The purpose of this article was to determine the value of FNA for the diagnosis and manage¬ ment of metastatic carcinoma to the thyroid. If FNA is to be useful, it should be sensitive, accurate, and cost effec¬ tive without adversely affecting clinical course and sur¬ vival.