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Background: Thyroid cancer is one of the most common endocrine malignancies secondary to ovarian cancer. Its incidence has surged swiftly than that of any other malignancy in recent years. Well-differentiated thyroid cancers (WDTC) are relatively common and usually slow-growing tumors with a good prognosis, including three types: Papillary, follicular, and Hürthle cell carcinoma. The first metastatic sites of these types of cancer typically involve lymph nodes, lungs, brain, and bones. Aim: To address the unusual sites of metastasis of well-differentiated thyroid cancer, which were not discussed in the literature before. Methods: The PICOT included adult men and women of 18 years and above, with the primary WDTC metastasized to unusual sites. MEDLINE, CINAHL, Cochrane Library, PubMed, Web of Science, Scopus, NCBI/PUBMED, Google Scholar were systematically screened for English language citations on human studies from 1990 to 2016. Results: The case reports found in literature were summarized in the form of tables including 8 cases of choroid plexus metastases, 22 cases of retropharyngeal node metastases, 5 cases of ovarian metastases, 22 cases of renal metastases, 6 cases of breast metastases, 8 cases of pancreatic metastases, 21 cases of choroid metastases, 10 cases of pituitary metastases, 54 cases of cardiac metastases, and one case of testicular metastases. Conclusion: Rare metastases of WDTC have been reported on distant sites such as kidneys, ovaries, heart, eyes, pancreas, pituitary, and testes. Major cases of uncommon metastases have been reported after several years of diagnosis of WDTC. Careful clinical diagnosis, along with advanced imaging techniques and immune-histopathological assays, can help to diagnose the type of tumor cells in host organs, which is essential for the development of treatment strategies.

Unusual Sites of Metastasis of Well-Differentiated Thyroid Cancer: A Systematic Review