Cutaneous Metastasis From a Classic Papillary Thyroid Cancer With Positive Immunohistochemical Staining for Sodium Iodide Symporter but No Response to Radioiodine TherapyWard, Laura Sterian MD, PhD*; Coelho Rezende, Carmem Alice MD†; Morari, Elaine Cristina PhD*; Camacho, Érico MD‡; Vassallo, Jose MD, PhD§Author Information From the *Laboratory of Cancer Molecular Genetics, Faculty of Medical Sciences School, State University of Campinas (UNICAMP), Sao Paulo, Brazil; †Department of Endocrinology, Samuel Libanio Hospital, University of Vale do Sapucai (UNIVAS), MG, Brazil; ‡Department of Nuclear Medicine, Pouso Alegre, MG, Brazil; and the §Molecular Pathology/Pathology Investigation Laboratory-CIPED, Faculty of Medical Sciences, State University of Campinas (UNICAMP), SP, Brazil. Reprints: Laura Sterian Ward, MD, PhD, Laboratory of Cancer Molecular Genetics, Faculty of Medical Sciences School, PO Box 6111, Campinas, SP, Brazil. E-mail: [email protected] The Endocrinologist: September/October 2009 - Volume 19 - Issue 5 - pp 214-217 doi: 10.1097/TEN.0b013e3181b5aa91 Buy Metrics Abstract A 76-year-old man presented with small reddish, painless nodular lesions of the chest and on neck surgical scars. The patient had, 5 years before, a T3N1M0 classic papillary thyroid carcinoma that evolved with recurrent cervical lymph node metastasis despite 3 surgeries and a cumulative dose of 500 mCi of 131Iodine. Investigations included the lesion biopsy and Tg immunohistochemistry, which led to the diagnosis of rare skin metastasis from a well differentiated thyroid tumor. The cutaneous lesions also tested positive for sodium iodide symporter protein, with clear membrane immunohistochemical staining. However, the patient did not respond to an additional dose of 400 mCi of radioiodine, suggesting a nonfunctional sodium iodide symporter protein. The lesions rapidly spread to the chest wall and erythematous red-purple inflamed nodules became confluent over a 3-month period. The tumor invaded the trachea causing the patient's death. © 2009 Lippincott Williams & Wilkins, Inc.