Habibullah Ammar H, Abdelmonim Sherif K, Aldajani Ahmad, Rajab Mohannad, Alessa Mohammad, Alkaf Haddad
Department of Otolaryngology Head and Neck Surgery, King Abdullah Medical City, Makkah, Saudi Arabia.
Department of Otolaryngology Head and Neck Surgery, University of Jeddah, Jeddah, Saudi Arabia.
Ann Med Surg (Lond). 2020 Jun 20;56:194-196. doi: 10.1016/j.amsu.2020.06.021. eCollection 2020 Aug.
Renal cell carcinoma is known to cause metastasis to unusual sites, but metastasis to the thyroid gland is a rare occurrence, not only that, but 20 years after complete recovery is almost nonexistent.
We are presenting here a case of 79-year-old female who presented to us for asymptomatic progressive thyroid nodule. She had history of right nephrectomy for renal cell carcinoma 20 years ago. Ultrasound guided fine needle aspiration biopsy (FNAB) of the thyroid was non-diagnostic. Total thyroidectomy of the patient was performed, and histopathological evaluation of the specimen revealed the swelling to be of metastatic in nature secondary to renal cell carcinoma.
Despite thyroid metastasis being rare, FNAB can prove to be useful tool for diagnosis of thyroid tumors and metastases and can be inconclusive in some cases. Therefore, immunohistochemistry can prove beneficial in diagnosis such cases.
The diagnosis of renal cell carcinoma metastasis is made after immunohistochemical evaluation of the thyroidectomy specimen with thyroidectomy proving to be the modality of treatment for such cases with no further radiation therapy and a yearly follow up plan to screen for other lesions.
已知肾细胞癌会转移至不常见的部位,但转移至甲状腺则较为罕见,不仅如此,在完全康复20年后出现这种情况几乎不存在。
我们在此呈现一例79岁女性患者,她因无症状性进行性甲状腺结节前来就诊。她20年前因肾细胞癌接受了右肾切除术。甲状腺超声引导下细针穿刺活检(FNAB)未得出诊断结果。对该患者实施了甲状腺全切术,标本的组织病理学评估显示该肿物为肾细胞癌继发的转移性肿物。
尽管甲状腺转移罕见,但FNAB可成为诊断甲状腺肿瘤和转移瘤的有用工具,不过在某些情况下可能无法得出结论。因此,免疫组织化学在诊断此类病例时可能有益。
肾细胞癌转移的诊断是在对甲状腺切除标本进行免疫组织化学评估后做出的,甲状腺切除术被证明是此类病例的治疗方式,无需进一步放疗,并制定了每年随访计划以筛查其他病变。