Endocrine Abstracts

Introduction: the coexistence of pulmonary adenocarcinoma and papillary thyroid carcinoma is a rare event. We report the case of a patient followed in consultation with thyroid carcinoma who was diagnosed with pulmonary adenocarcinoma.

Observation: This is a 67-year-old patient, who had a total thyroidectomy for a multiheteronodular goitre with dissection of a pretracheal lymph node. Histopathological examination revealed a multifocal grade 1 thyroid papillary carcinoma, 3 cm long, with reactive adenitis on the pretracheal lymph node, classified as pT2N0Mx. Radioactive iodine therapy was performed. The patient presented 2 years after the surgery an episode of pneumonia with deterioration of the general state; a chest scan revealed an 8.8 cm right lower mediastinum-pulmonary tissue process, the diagnosis of mucinous adenocarcinoma was confirmed after lung biopsy. The immunohistochemical study was carried out and showed an expression of CK7 without expression of thyroglobulin. A positron emission tomography (PET scan) performed as part of an extension assessment, objectified a hypermetabolic pulmonary process of the right lower lobe associated with a slightly hypermetabolic micronodular infiltrate perilesional with hypermetabolic microfocus of segment II of the liver.

Conclusion: The coexistence of several neoplasias is rare, and poses major diagnostic and therapeutic problems, worsening the prognosis and requiring multidisciplinary management.