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Metastatic colorectal cancer to a primary thyroid cancer.

Cherk MH, Moore M, Serpell J, Swain S, Topliss DJ - World J Surg Oncol (2008)

Bottom Line: Metastatic malignancy to the thyroid gland is generally uncommon due to an unfavourable local thyroid micro-environment which impairs the ability of metastatic cells to settle and thrive.Metastases to the thyroid gland have however been reported to occur occasionally particularly if there has been disruption to normal thyroid tissue architecture.Metastatic rectal carcinoma to the thyroid gland and in particular to a primary thyroid malignancy is rare and unusual.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Nuclear Medicine, the Alfred Hospital, Commercial Road, Melbourne Victoria 3004, Australia. m_cherk@yahoo.com.au

ABSTRACT

Background: Metastatic malignancy to the thyroid gland is generally uncommon due to an unfavourable local thyroid micro-environment which impairs the ability of metastatic cells to settle and thrive. Metastases to the thyroid gland have however been reported to occur occasionally particularly if there has been disruption to normal thyroid tissue architecture.

Case presentation: We report a patient with a history of surgically resected rectal adenocarcinoma who presents with a rising serum CEA level and an 18F-FDG PET scan positive thyroid nodule which was subsequently confirmed at surgery to be a focus of metastatic rectal adenocarcinoma within a primary poorly differentiated papillary thyroid carcinoma.Subsequent treatment involved right hemi-thyroidectomy, pulmonary wedge resection of oligometastatic metastatic colorectal cancer and chemotherapy.

Conclusion: Metastatic rectal carcinoma to the thyroid gland and in particular to a primary thyroid malignancy is rare and unusual. Prognosis is likely to be more dependent on underlying metastatic disease rather than the primary thyroid malignancy hence primary treatments should be tailored towards treating and controlling metastatic disease and less emphasis placed on the primary thyroid malignancy.

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Histological examination of the thyroid nodule revealed (A) poorly differentiated primary papillary thyroid carcinoma intermixed with (B) foci of metastatic rectal adenocarcinoma i H&E Low power ×10 ii H&E High Power ×20.
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Figure 3: Histological examination of the thyroid nodule revealed (A) poorly differentiated primary papillary thyroid carcinoma intermixed with (B) foci of metastatic rectal adenocarcinoma i H&E Low power ×10 ii H&E High Power ×20.

Mentions: An ultrasound guided fine needle aspirate of the right lower pole thyroid nodule was performed which revealed malignant cells with features suggestive of a primary papillary thyroid cancer. A right hemi-thyroidectomy was subsequently performed. Macroscopically, the resected thyroid specimen demonstrated a well-circumscribed dominant thyroid nodule measuring 32 mm in diameter with a pale tan capsule less than 1 mm in thickness. The cut surface had a variegated appearance with pale tan friable tissue intermixed with foci of yellow tissue and dark brown foci. Histological examination revealed cells typical of metastatic adenocarcinoma of the colon intermixed in a background of a poorly differentiated papillary thyroid carcinoma (figure 3).


Metastatic colorectal cancer to a primary thyroid cancer.

Cherk MH, Moore M, Serpell J, Swain S, Topliss DJ - World J Surg Oncol (2008)

Histological examination of the thyroid nodule revealed (A) poorly differentiated primary papillary thyroid carcinoma intermixed with (B) foci of metastatic rectal adenocarcinoma i H&E Low power ×10 ii H&E High Power ×20.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2588591&req=5

Figure 3: Histological examination of the thyroid nodule revealed (A) poorly differentiated primary papillary thyroid carcinoma intermixed with (B) foci of metastatic rectal adenocarcinoma i H&E Low power ×10 ii H&E High Power ×20.
Mentions: An ultrasound guided fine needle aspirate of the right lower pole thyroid nodule was performed which revealed malignant cells with features suggestive of a primary papillary thyroid cancer. A right hemi-thyroidectomy was subsequently performed. Macroscopically, the resected thyroid specimen demonstrated a well-circumscribed dominant thyroid nodule measuring 32 mm in diameter with a pale tan capsule less than 1 mm in thickness. The cut surface had a variegated appearance with pale tan friable tissue intermixed with foci of yellow tissue and dark brown foci. Histological examination revealed cells typical of metastatic adenocarcinoma of the colon intermixed in a background of a poorly differentiated papillary thyroid carcinoma (figure 3).

Bottom Line: Metastatic malignancy to the thyroid gland is generally uncommon due to an unfavourable local thyroid micro-environment which impairs the ability of metastatic cells to settle and thrive.Metastases to the thyroid gland have however been reported to occur occasionally particularly if there has been disruption to normal thyroid tissue architecture.Metastatic rectal carcinoma to the thyroid gland and in particular to a primary thyroid malignancy is rare and unusual.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Nuclear Medicine, the Alfred Hospital, Commercial Road, Melbourne Victoria 3004, Australia. m_cherk@yahoo.com.au

ABSTRACT

Background: Metastatic malignancy to the thyroid gland is generally uncommon due to an unfavourable local thyroid micro-environment which impairs the ability of metastatic cells to settle and thrive. Metastases to the thyroid gland have however been reported to occur occasionally particularly if there has been disruption to normal thyroid tissue architecture.

Case presentation: We report a patient with a history of surgically resected rectal adenocarcinoma who presents with a rising serum CEA level and an 18F-FDG PET scan positive thyroid nodule which was subsequently confirmed at surgery to be a focus of metastatic rectal adenocarcinoma within a primary poorly differentiated papillary thyroid carcinoma.Subsequent treatment involved right hemi-thyroidectomy, pulmonary wedge resection of oligometastatic metastatic colorectal cancer and chemotherapy.

Conclusion: Metastatic rectal carcinoma to the thyroid gland and in particular to a primary thyroid malignancy is rare and unusual. Prognosis is likely to be more dependent on underlying metastatic disease rather than the primary thyroid malignancy hence primary treatments should be tailored towards treating and controlling metastatic disease and less emphasis placed on the primary thyroid malignancy.

Show MeSH
Related in: MedlinePlus