Endocrine Abstracts

Introduction: Papillary thyroid carcinoma (PTC) has generally good prognosis, and distant spread is rare. Common sites of distant metastasis are lung parenchyma and bone. Pleural metastasis is less common (0.6%), and most cases have been detected because of pleural effusion. Malignant pleural effusion is a poor prognostic factor among patients with PTC. We report a case of pleural metastasis of PTC proved by pleural biopsy.

Case report: A 62-year-old man was referred to our unit for pleural effusion and lung metastases which pleural biopsy showed the thyroid origin. He had undergone total thyroidectomy. Histopathological examination revealed a multifocal thyroid papillary carcinoma (PT3NXM2). Up-take scan after radioiodine therapy was positive in cervical and lungs. After pathological diagnosis, the serum thyroglobulin level was 6090 ng/ml. The rest of the staging (cerebro spinal MRI and bone scan) came back without abnormalities.

Conclusion: Pleural metastases of thyroid carcinomas are rare and usually occur in a context of metastatic spread. Their specific management is difficult because of the recurrent nature of the effusion. The median survival duration after pleural effusion development is reported to be <1 year, and most reported cases have had poor prognoses.