Endocrine Abstracts (2017) 49 EP1464 | DOI: 10.1530/endoabs.49.EP1464

Two cases with metastatic thyroid cancer

Murat Dagdeviren1, Mustafa Altay1, Ozge Safak2 & Tolga Akkan3

1Endocrinology and Metabolism, Keciören Education and Research Hospital, Ankara, Turkey; 2Sanatoryum Education and Research Hospital, Ankara, Turkey; 3Internal Medicine, Keciören Education and Research Hospital, Ankara, Turkey.

Although the thyroid gland has an abundant blood supply, metastasis to the thyroid gland is a rare condition. Its incidence varies from 0.1% and 3% in clinical series. First case. A 56-year-old man presented to emergency service with neurological symptoms. CT of brain revealed multiple hyperdens lesions. Posteroanterior chest X-ray showed increased opacity in the left lung. Metastatic lung cancer was considered as a preliminary diagnosis and PET/CT was performed. PET/CT showed a mass lesion of 15.8×7.6×8.5 cm in the upper lobe of the left lung and multiple pathologic involvements with metastatic appearance were present in many organs, especially in thyroid gland. A biopsy was performed from the mass lesion and biopsy revealed squamous cell lung cancer. FNA was performed from a nodule located in the right thyroid lobe and cytopathological analysis of aspiration material showed metastatic epithelial carcinoma. Second case. A 42-year-old man presented with fatigue, dyspnea and cough. Thorax CT revealed a nodular lesion of 27×17 mm in posterior segment of the right upper lobe. PET/CT showed increased FDG uptake in the lung, mediastinum and abdominal multiple lymph node regions, thyroid gland and skeletal system. Biopsy was performed with fiberoptic bronchoscopy and the result was consistent with primary adenocarcinoma of the lung. FNA was performed from a nodule located in the right thyroid lobe and from a suspicious right cervical lymph node in level III. Cytopathological analysis of both aspiration materials revealed metastasis of malign epithelial carcinoma. It was thought that medical palliative approach would be more appropriate treatment option for two cases when presence of multiple synchronous metastases, absence of local symptoms, characterization of primary diseases, general condition and life expectancies of the patients considered. Discussion. It should be known that the treatment approach in patients with metastatic thyroid cancer affects survival and treatment should be individualized.

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