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Perigastric lymph node metastasis from papillary thyroid carcinoma in a patient with early gastric cancer: the first case report.

Jeong GA, Kim HC, Kim HK, Cho GS - J Gastric Cancer (2014)

Bottom Line: During post-surgical follow-up for breast cancer, a 56-year-old woman was diagnosed incidentally with early gastric cancer and synchronous left thyroid cancer.Finally, on the basis of immunohistochemical staining with galectin-3, the diagnosis of perigastric lymph node metastasis from PTC was made.When a patient has multiple primary malignancies with lymph node metastasis, careful pathologic examination of the surgical specimen is necessary; immunohistochemical staining may be helpful in determining the primary origin of lymph node metastasis.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.

ABSTRACT
Distant metastasis from papillary thyroid carcinoma (PTC), particularly from papillary thyroid microcarcinoma, is rare. We present a case of perigastric lymph node metastasis from PTC in a patient with early gastric cancer and breast cancer. During post-surgical follow-up for breast cancer, a 56-year-old woman was diagnosed incidentally with early gastric cancer and synchronous left thyroid cancer. Therefore, laparoscopic distal gastrectomy with lymph node dissection and left thyroidectomy were performed. On the basis of the pathologic findings of the surgical specimens, the patient was diagnosed to have papillary thyroid microcarcinoma with perigastric lymph node metastasis and early gastric cancer with mucosal invasion. Finally, on the basis of immunohistochemical staining with galectin-3, the diagnosis of perigastric lymph node metastasis from PTC was made. When a patient has multiple primary malignancies with lymph node metastasis, careful pathologic examination of the surgical specimen is necessary; immunohistochemical staining may be helpful in determining the primary origin of lymph node metastasis.

No MeSH data available.


Related in: MedlinePlus

Thyroid ultrasonography showing a solid oval-shaped nodule (0.87 cm) with multiple tiny calcifications in the upper pole of the left thyroid gland.
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Figure 2: Thyroid ultrasonography showing a solid oval-shaped nodule (0.87 cm) with multiple tiny calcifications in the upper pole of the left thyroid gland.

Mentions: A 56-year-old woman was referred to our hospital for the surgical treatment of gastric cancer in September 2006. She had a medical history of hypothyroidism, and 3 months before, she had undergone lumpectomy with axillary lymph node dissection for left breast invasive ductal carcinoma at a different hospital. During a follow-up esophagogastroduodenoscopy, she was diagnosed incidentally with early gastric cancer (Fig. 1). Endoscopic biopsy revealed moderately differentiated tubular adenocarcinoma in the midbody of the anterior abdominal wall. Abdominal computed tomography (CT) revealed neither regional lymph node metastasis nor distant metastasis. Because the patient had a history of hypothyroidism, we performed ultrasonography for further evaluation of the thyroid. A small calcified mass was detected in the upper pole of the left thyroid gland (Fig. 2), and fine-needle aspiration biopsy (FNAB) was performed to rule out thyroid malignancy. Although fine-needle aspiration revealed lymphocytic thyroiditis without evidence of malignancy, the thyroid ultrasonographic findings indicated a high possibility of thyroid malignancy; therefore, we planned thyroidectomy with gastrectomy for gastric cancer. The patient underwent laparoscopy-assisted distal gastrectomy, loop gastrojejunostomy, and D2 lymphadenectomy for gastric cancer, and left thyroidectomy with isthmectomy and central lymph node dissection for the left thyroid mass. The operation took 345 minutes, and there were no intraoperative complications.


Perigastric lymph node metastasis from papillary thyroid carcinoma in a patient with early gastric cancer: the first case report.

Jeong GA, Kim HC, Kim HK, Cho GS - J Gastric Cancer (2014)

Thyroid ultrasonography showing a solid oval-shaped nodule (0.87 cm) with multiple tiny calcifications in the upper pole of the left thyroid gland.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4199891&req=5

Figure 2: Thyroid ultrasonography showing a solid oval-shaped nodule (0.87 cm) with multiple tiny calcifications in the upper pole of the left thyroid gland.
Mentions: A 56-year-old woman was referred to our hospital for the surgical treatment of gastric cancer in September 2006. She had a medical history of hypothyroidism, and 3 months before, she had undergone lumpectomy with axillary lymph node dissection for left breast invasive ductal carcinoma at a different hospital. During a follow-up esophagogastroduodenoscopy, she was diagnosed incidentally with early gastric cancer (Fig. 1). Endoscopic biopsy revealed moderately differentiated tubular adenocarcinoma in the midbody of the anterior abdominal wall. Abdominal computed tomography (CT) revealed neither regional lymph node metastasis nor distant metastasis. Because the patient had a history of hypothyroidism, we performed ultrasonography for further evaluation of the thyroid. A small calcified mass was detected in the upper pole of the left thyroid gland (Fig. 2), and fine-needle aspiration biopsy (FNAB) was performed to rule out thyroid malignancy. Although fine-needle aspiration revealed lymphocytic thyroiditis without evidence of malignancy, the thyroid ultrasonographic findings indicated a high possibility of thyroid malignancy; therefore, we planned thyroidectomy with gastrectomy for gastric cancer. The patient underwent laparoscopy-assisted distal gastrectomy, loop gastrojejunostomy, and D2 lymphadenectomy for gastric cancer, and left thyroidectomy with isthmectomy and central lymph node dissection for the left thyroid mass. The operation took 345 minutes, and there were no intraoperative complications.

Bottom Line: During post-surgical follow-up for breast cancer, a 56-year-old woman was diagnosed incidentally with early gastric cancer and synchronous left thyroid cancer.Finally, on the basis of immunohistochemical staining with galectin-3, the diagnosis of perigastric lymph node metastasis from PTC was made.When a patient has multiple primary malignancies with lymph node metastasis, careful pathologic examination of the surgical specimen is necessary; immunohistochemical staining may be helpful in determining the primary origin of lymph node metastasis.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.

ABSTRACT
Distant metastasis from papillary thyroid carcinoma (PTC), particularly from papillary thyroid microcarcinoma, is rare. We present a case of perigastric lymph node metastasis from PTC in a patient with early gastric cancer and breast cancer. During post-surgical follow-up for breast cancer, a 56-year-old woman was diagnosed incidentally with early gastric cancer and synchronous left thyroid cancer. Therefore, laparoscopic distal gastrectomy with lymph node dissection and left thyroidectomy were performed. On the basis of the pathologic findings of the surgical specimens, the patient was diagnosed to have papillary thyroid microcarcinoma with perigastric lymph node metastasis and early gastric cancer with mucosal invasion. Finally, on the basis of immunohistochemical staining with galectin-3, the diagnosis of perigastric lymph node metastasis from PTC was made. When a patient has multiple primary malignancies with lymph node metastasis, careful pathologic examination of the surgical specimen is necessary; immunohistochemical staining may be helpful in determining the primary origin of lymph node metastasis.

No MeSH data available.


Related in: MedlinePlus