Hassan Muhammad, Janjua Taimoor Khalid, Afridi Hira Khan, Zahid Naila Anjum
Department of Medicine, Jinnah Post Graduate Medical Centre, Karachi, Pakistan.
Liaquat National Hospital and Medical College, Karachi, Pakistan.
BMJ Case Rep. 2017 Jul 13;2017:bcr-2017-220793. doi: 10.1136/bcr-2017-220793.
Anaplastic thyroid cancer is the rarest tumour of the thyroid gland, representing only 2% of clinically recognised thyroid cancers. The most common metastatic sites are lungs, followed by the intrathoracic and neck lymph nodes. We report the case of a 62-year-old woman who presented to our setting with multiple soft tissue nodules, thyroid mass, head swelling and weight loss. Radiological investigation showed a large thyroid mass with widespread metastasis in subcutaneous tissues of both upper limbs, chest and abdomen. Metastasis was also found in lungs, skull and adrenal glands after which the patient was diagnosed with stage IVc anaplastic thyroid carcinoma (ATC). After careful consideration of patient's clinical condition with multiple poor prognostic factors, medical therapy was withheld and she was discharged on hospice care. The patient expired after 1 month. In ATC, metastasis to subcutaneous tissue is an extremely rare occurrence of which there is hardly any evidence in literature.
间变性甲状腺癌是甲状腺最罕见的肿瘤,仅占临床确诊甲状腺癌的2%。最常见的转移部位是肺,其次是胸内和颈部淋巴结。我们报告了一例62岁女性病例,该患者因多个软组织结节、甲状腺肿块、头部肿胀和体重减轻前来就诊。影像学检查显示甲状腺有一个大肿块,上肢、胸部和腹部的皮下组织广泛转移。肺部、颅骨和肾上腺也发现了转移,之后患者被诊断为IVc期间变性甲状腺癌(ATC)。在仔细考虑患者存在多个不良预后因素的临床情况后,未给予药物治疗,患者出院接受临终关怀。患者在1个月后死亡。在ATC中,转移至皮下组织极为罕见,文献中几乎没有相关证据。