Metastatic Papillary Thyroid Carcinoma Gone Wild
Bibliographic record
Abstract
Thyroid cancers account for only 1.5% of all cancers in adults and 3% of all cancers in children. In females, however, thyroid cancers are the fifth most common cancer, comprising 4% of all cases. Of all thyroid cancers, 74-80% of cases are papillary cancer. The prevalence of thyroid cancer is rising worldwide. Although thyroid cancer has a favorable prognosis, up to 20% of patients experienced recurrent disease during the follow-up period. Extra-thyroidal extension occurs in 8% to 32% of cases. Local or regional recurrences occur in 5-15% of patients with papillary thyroid carcinoma (PTC). Distant metastasis occurs in only 1% to 25% mostly in the lungs and bones. Our patient is a 68-year-old woman with a past medical history of hypertension and endometriosis. She has metastatic PTC with recurrent metastasis. She had a subtotal thyroidectomy in 2004; radioactive iodine ablation of residual cancer with two recurrent metastases at the right lateral supraclavicular mass and skull base; underwent multiple neck surgeries and resection of skull base lesion in 2014; and local neck resection of right lateral supraclavicular neck mass in 2017. She presented this time with a 6-month history of right submaxillary and right infra-auricular growth. The patient underwent an ultrasound-guided biopsy of tonsillar and submaxillary masses with pathology consistent with PTC. In 2020, the patient was found to have parotid gland involvement. Biopsy of the parotid gland confirmed PTC cells. Recently in 2021 whole-body positron emission tomography/computed tomography (PET/CT) showed early bone metastasis. This case report exemplifies a highly aggressive PTC with recurrent metastases to sites that have rarely been reported in the past. It also draws our attention to the unknown prognosis of such aggressive metastatic PTC. The presence of metastatic lesions at uncommon sites such as the tonsils, vocal cord, parotid gland, oropharynx and bone metastasis should direct our focus toward a need for further research on metastatic PTC to establish improved management strategies. J Endocrinol Metab. 2023;13(3):121-125 doi: https://doi.org/10.14740/jem764
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.017 | 0.005 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".