Clinical observation of metastatic thyroid disease in a patient with breast cancer

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Abstract

Metastatic tumors of the thyroid gland (TG) are rare. Usually thyroid gland metastases originate from renal, lung, skin and gastrointestinal cancers. Breast cancer metastases are more rare and in various samples amount to 3 to 34% of all cases of the metastatic thyroid disease. We present a rare case of metastatic carcinomatosis into the thyroid goiter in a 63-year old female patient who has received combination therapy for breast cancer. In 2016, right-sided mastectomy was performed due to the right breast cancer (invasive carcinoma, non-specific type, Grade 2, with skin invasion) with subsequent four chemotherapy courses. A slowly growing nodule in the thyroid gland was first found in 2012; in 2017, fine needle aspiration biopsy was performed, which showed a follicular tumor that resulted in thyroidectomy. At the histological examination, against the background of thyroid goiter, multiple small lesions with advanced nuclear polymorphism were found, with doubtful diagnosis. To clarify the histogenesis of the tumor lesions, immunohistochemical assessment was performed. Its first phase included the markers of primary thyroid tumors (thyroglobulin, TTF-1), and the second one consisted of the breast cancer diagnostic panel (mammoglobin, GATA-3, estrogen and progesterone receptors). The results showed multiple small metastases of the invasive breast carcinoma of non-specific type into the thyroid goiter. Taking into account eventual problems of differential diagnosis and significant morphological polymorphism of thyroid tumors, we recommend extending of the immunohistochemistry panel in this patient category.

About the authors

E. V. Bondarenko

Moscow Regional Research and Clinical Institute (MONIKI)

Author for correspondence.
Email: ekaterinabondarenko@inbox.ru

Ekaterina V. Bondarenko – Research Fellow, Department of Pathological Anatomy

61/2-13 Shchepkina ul., Moscow, 129110

Russian Federation

L. E. Gurevich

Moscow Regional Research and Clinical Institute (MONIKI)

Email: fake@neicon.ru

Larisa E. Gurevich – ScD in Biology, Professor, Leading Research Fellow, Department of Pathological Anatomy

61/2 Shchepkina ul., Moscow, 129110

Russian Federation

I. V. Kotova

Moscow Regional Research and Clinical Institute (MONIKI)

Email: fake@neicon.ru

Irina V. Kotova – MD, PhD, Leading Research Fellow, Department of Endocrine Surgery

61/2 Shchepkina ul., Moscow, 129110

Russian Federation

References

  1. Straccia P, Mosseri C, Brunelli C, Rossi ED, Lombardi CP, Pontecorvi A, Fadda G. Diagnosis and treatment of metastases to the thyroid gland: a meta-analysis. Endocr Pathol. 2017;28(2): 112–20. doi: 10.1007/s12022-017-9475-6.
  2. Chung AY, Tran TB, Brumund KT, Weisman RA, Bouvet M. Metastases to the thyroid: a review of the literature from the last decade. Thyroid. 2012;22(3): 258–68. doi: 10.1089/thy.2010.0154.
  3. Moghaddam PA, Cornejo KM, Khan A. Metastatic carcinoma to the thyroid gland: a single institution 20-year experience and review of the literature. Endocr Pathol. 2013;24(3): 116– 24. doi: 10.1007/s12022-013-9257-8.
  4. Plonczak AM, DiMarco AN, Dina R, Gujral DM, Palazzo FF. Breast cancer metastases to the thyroid gland – an uncommon sentinel for diffuse metastatic disease: a case report and review of the literature. J Med Case Rep. 2017;11(1): 269. doi: 10.1186/s13256-017-1441-x.
  5. Hegerova L, Griebeler ML, Reynolds JP, Henry MR, Gharib H. Metastasis to the thyroid gland: report of a large series from the Mayo Clinic. Am J Clin Oncol. 2015;38(4): 338–42. doi: 10.1097/COC.0b013e31829d1d09.
  6. Russell JO, Yan K, Burkey B, Scharpf J. Nonthyroid metastasis to the thyroid gland: case series and review with observations by primary pathology. Otolaryngol Head Neck Surg. 2016;155(6): 961–8. doi: 10.1177/0194599816655783.
  7. Melis C, Ballaux F, Bourgain C. Curious residents of the thyroid gland: two case reports of colorectal carcinoma metastasis by fine-needle aspiration diagnosis. Acta Cytol. 2018;13:1–7. doi: 10.1159/000490367[Epub ahead of print].
  8. Lam KY, Lo CY. Metastatic tumors of the thyroid gland: a study of 79 cases in Chinese patients. Arch Pathol Lab Med. 1998;122(1): 37–41.
  9. Falcone R, Ramundo V, Lamartina L, Ascoli V, Bosco D, Di Gioia C, Montesano T, Biffoni M, Bononi M, Giacomelli L, Minni A, Segni M, Maranghi M, Cantisani V, Durante C, Grani G. Sonographic presentation of metastases to the thyroid gland: a case series. J Endocr Soc. 2018;2(8): 855–9. doi: 10.1210/js.2018-00124.
  10. Lloyd RV, Osamura RY, Kloppel G, Rosai J, editors. World Health Organization Classification of Tumours of Endocrine Organs. 4th edition. WHO Classification of Tumours. Vol. 10. Lyon: IARC; 2017. 355 p.
  11. Гервальд ВЯ, Климачев ВВ, Авдалян АМ, Иванов АА, Бобров ИП, Лепилов АВ, Черданцева ТМ, Мяделец МН, Лазарев АФ, Таранина ТС, Самуйленкова ОВ, Рагулина ВД. Рак щитовидной железы и методы его иммуногистохимической диагностики. Фундаментальные исследования. 2014;(10–10): 1911–7 [Интернет]. Доступно на: http://fundamental-research.ru/ru/article/view?id=36670 (дата обращения: 05.08.2018).

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Copyright (c) 2018 Bondarenko E.V., Gurevich L.E., Kotova I.V.

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