Al-Abed Yahya, Gray Emma, Wolfe Konrad, Watters Gavin W, Philpott Jonathan M
The Breast Unit, Department of Surgery, Southend University Hospital, Prittlewell Chase, Westcliff-on-Sea, Essex SS0 0RY, UK.
Int Semin Surg Oncol. 2008 May 27;5:14. doi: 10.1186/1477-7800-5-14.
Hurthle cell carcinoma of the thyroid is a rare form of thyroid cancer. It may present as a low grade tumour or can present as a more aggressive metastatic carcinoma. Hurthle cell carcinoma has the highest incidence of metastasis among all differentiated thyroid cancers. Most commonly haematogenous spread to lungs, bones and brain, however spread to regional lymph nodes is not uncommon. The breast is a rare site for metastasis from extramammary sources. We present the first case of breast metastasis from Hurthle cell carcinoma of the thyroid.
We report a 77 year old lady who had total thyroidectomy and bilateral neck dissection followed by radiotherapy for a high grade metastatic Hurthle cell carcinoma of the thyroid. Ten months later she presented to the breast clinic with left breast lump and a lump at the left axilla. Fine needle aspiration cytology of the lumps and histology after wide local excision of the breast lump confirmed metastatic Hurthle cell carcinoma.
The presence of breast lumps in patients with history of extramammary cancer should raise the possibility of metastasis.
甲状腺嗜酸性细胞癌是一种罕见的甲状腺癌形式。它可能表现为低级别肿瘤,也可能表现为侵袭性更强的转移性癌。在所有分化型甲状腺癌中,嗜酸性细胞癌的转移发生率最高。最常见的是血行转移至肺、骨和脑,然而转移至区域淋巴结也并不罕见。乳腺是来自乳腺外来源转移的罕见部位。我们报告了首例甲状腺嗜酸性细胞癌转移至乳腺的病例。
我们报告一位77岁女性,因高级别转移性甲状腺嗜酸性细胞癌接受了甲状腺全切术和双侧颈淋巴结清扫术,随后进行了放疗。十个月后,她因左侧乳腺肿块和左侧腋窝肿块就诊于乳腺科。肿块的细针穿刺细胞学检查以及乳腺肿块广泛局部切除后的组织学检查证实为转移性嗜酸性细胞癌。
有乳腺外癌症病史的患者出现乳腺肿块应提高转移的可能性。