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Palliative thyroidectomy in the setting of a metastatic renal cell carcinoma.

Krishnamurthy A, Deen S, Ramshankar V, Majhi U - Indian J Nucl Med (2014)

Bottom Line: A secondary neoplasm of the thyroid gland is a distinctly uncommon cause of thyroid enlargement.This association needs to be further explored as also the role of palliative thyroidectomy in the setting of a metastatic RCC.The possibility of metastatic RCC should be kept as a differential during the course of the evaluation of clear cell renal tumor of the thyroid gland.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgical Oncology, Cancer Institute (WIA), Adyar, Chennai, Tamil Nadu, India.

ABSTRACT
A secondary neoplasm of the thyroid gland is a distinctly uncommon cause of thyroid enlargement. These tumors mimic primary thyroid gland tumors and often lead to diagnostic difficulties. We report an interesting case of secondary thyroid tumor coexisting with a micropapillary carcinoma in an elderly male patient following a radical nephrectomy done 15 years prior for a renal cell carcinoma (RCC). Interestingly, the previously described coincidental association of thyroid and pancreatic metastases in a metastatic RCC was also noted in our patient as was demonstrated in the positron emission tomography-computed tomography which was done as part of the metastatic workup. This association needs to be further explored as also the role of palliative thyroidectomy in the setting of a metastatic RCC. The possibility of metastatic RCC should be kept as a differential during the course of the evaluation of clear cell renal tumor of the thyroid gland.

No MeSH data available.


Related in: MedlinePlus

(a and b) Microscopy examination of the thyroidectomy specimen revealed a neoplasm arranged as nests of cells with round to oval nuclei, clear cytoplasm, and fibro-vascular septa. The thyroid follicles were compressed at periphery, capsular infiltration (H and E, ×20) (c) Vascular tumor emboli (H and E, ×10). (d) An additional focus of papillary micro carcinoma in the left lobe of the thyroid (H and E, ×10)
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Figure 4: (a and b) Microscopy examination of the thyroidectomy specimen revealed a neoplasm arranged as nests of cells with round to oval nuclei, clear cytoplasm, and fibro-vascular septa. The thyroid follicles were compressed at periphery, capsular infiltration (H and E, ×20) (c) Vascular tumor emboli (H and E, ×10). (d) An additional focus of papillary micro carcinoma in the left lobe of the thyroid (H and E, ×10)

Mentions: A palliative total thyroidectomy [Figure 3a and b] was contemplated in view of the compressive and obstructive symptoms, the final histopathology of which revealed an 8 cm × 7 cm × 4.5 cm tumor replacing entire right lobe of the thyroid, which on microscopy revealed a neoplasm arranged as nests of cells with round to oval nuclei, clear cytoplasm, and fibro-vascular septa. The thyroid follicles were compressed at periphery, capsular infiltration, and occasional vascular tumor emboli were also noted. The final diagnosis confirmed the preoperative diagnosis of metastatic RCC, clear cell type, Fuhrmann grade III, with an additional focus of papillary micro carcinoma in the left lobe of the thyroid [Figures 4a-d, 5a-d]. The patient made an uneventful recovery and was subsequently started on targeted therapy (tablet sunitinib 50 mg orally once a day) and continues to be on follow-up for 4 months, relieved of his compressive symptoms.


Palliative thyroidectomy in the setting of a metastatic renal cell carcinoma.

Krishnamurthy A, Deen S, Ramshankar V, Majhi U - Indian J Nucl Med (2014)

(a and b) Microscopy examination of the thyroidectomy specimen revealed a neoplasm arranged as nests of cells with round to oval nuclei, clear cytoplasm, and fibro-vascular septa. The thyroid follicles were compressed at periphery, capsular infiltration (H and E, ×20) (c) Vascular tumor emboli (H and E, ×10). (d) An additional focus of papillary micro carcinoma in the left lobe of the thyroid (H and E, ×10)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4228598&req=5

Figure 4: (a and b) Microscopy examination of the thyroidectomy specimen revealed a neoplasm arranged as nests of cells with round to oval nuclei, clear cytoplasm, and fibro-vascular septa. The thyroid follicles were compressed at periphery, capsular infiltration (H and E, ×20) (c) Vascular tumor emboli (H and E, ×10). (d) An additional focus of papillary micro carcinoma in the left lobe of the thyroid (H and E, ×10)
Mentions: A palliative total thyroidectomy [Figure 3a and b] was contemplated in view of the compressive and obstructive symptoms, the final histopathology of which revealed an 8 cm × 7 cm × 4.5 cm tumor replacing entire right lobe of the thyroid, which on microscopy revealed a neoplasm arranged as nests of cells with round to oval nuclei, clear cytoplasm, and fibro-vascular septa. The thyroid follicles were compressed at periphery, capsular infiltration, and occasional vascular tumor emboli were also noted. The final diagnosis confirmed the preoperative diagnosis of metastatic RCC, clear cell type, Fuhrmann grade III, with an additional focus of papillary micro carcinoma in the left lobe of the thyroid [Figures 4a-d, 5a-d]. The patient made an uneventful recovery and was subsequently started on targeted therapy (tablet sunitinib 50 mg orally once a day) and continues to be on follow-up for 4 months, relieved of his compressive symptoms.

Bottom Line: A secondary neoplasm of the thyroid gland is a distinctly uncommon cause of thyroid enlargement.This association needs to be further explored as also the role of palliative thyroidectomy in the setting of a metastatic RCC.The possibility of metastatic RCC should be kept as a differential during the course of the evaluation of clear cell renal tumor of the thyroid gland.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgical Oncology, Cancer Institute (WIA), Adyar, Chennai, Tamil Nadu, India.

ABSTRACT
A secondary neoplasm of the thyroid gland is a distinctly uncommon cause of thyroid enlargement. These tumors mimic primary thyroid gland tumors and often lead to diagnostic difficulties. We report an interesting case of secondary thyroid tumor coexisting with a micropapillary carcinoma in an elderly male patient following a radical nephrectomy done 15 years prior for a renal cell carcinoma (RCC). Interestingly, the previously described coincidental association of thyroid and pancreatic metastases in a metastatic RCC was also noted in our patient as was demonstrated in the positron emission tomography-computed tomography which was done as part of the metastatic workup. This association needs to be further explored as also the role of palliative thyroidectomy in the setting of a metastatic RCC. The possibility of metastatic RCC should be kept as a differential during the course of the evaluation of clear cell renal tumor of the thyroid gland.

No MeSH data available.


Related in: MedlinePlus