Al-Janabi Moatasem Hussein, Zainab Haneen, Wannous Hiba, Dowaji Maria, Zainab Deema, Rasheed Omeed, Kannan Samir, Issa Rana
Department of Pathology, Cancer Research Center.
Faculty of Medicine.
Ann Med Surg (Lond). 2023 Apr 18;85(5):2162-2165. doi: 10.1097/MS9.0000000000000682. eCollection 2023 May.
Metastasis of squamous cell lung carcinoma to the thyroid gland is an extremely rare event. It frequently metastasizes to lymph nodes, liver, adrenal glands, bone, brain, and pleura. Among the lung carcinomas metastasizing to the thyroid, adenocarcinomas are the most common followed by squamous cell carcinomas (SCCs).
A 58-year-old male patient presented with bilateral neck swelling. Fine needle aspiration is performed and was undetermined. Ultrasonography of the neck demonstrated multiple hypoechoic nodules with thyroid enlargement. The patient was diagnosed with nodular goitre and he underwent a total thyroidectomy. Microscopically, the Hematoxylin and eosin-stained sections revealed thyroid follicles with sheets composed of polygonal cells with pleomorphic nuclei, prominent nucleoli, and a moderate amount of eosinophilic cytoplasm. Keratin pearls were present. Based on histopathological and clinical findings, the final diagnosis was metastatic SCC to the thyroid gland.
Clinically, patients with thyroid metastasis presented with nonspecific symptoms such as thyroid nodule or goitre, cervical discomfort, dyspnoea, dysphagia, or dysphonia. Chemotherapy is used in the case of a poly metastatic tumour and radiotherapy as a palliative treatment whereas radioiodine treatment is not indicated for thyroid metastases.
Diagnosis of SCC in the thyroid gland as a primary or metastatic neoplasm is a significant challenge. In the absence of specific clinical or radiological signs, pathological studies remain the gold standard for diagnosis.
肺鳞状细胞癌转移至甲状腺极为罕见。它常转移至淋巴结、肝脏、肾上腺、骨骼、脑和胸膜。在转移至甲状腺的肺癌中，腺癌最为常见，其次是鳞状细胞癌（SCC）。
一名58岁男性患者出现双侧颈部肿胀。进行了细针穿刺活检，但结果未明确。颈部超声显示甲状腺肿大，有多个低回声结节。该患者被诊断为结节性甲状腺肿，并接受了甲状腺全切术。显微镜下，苏木精和伊红染色切片显示甲状腺滤泡，有由多边形细胞组成的片状结构，细胞核多形性，核仁明显，有中等量嗜酸性细胞质。可见角化珠。根据组织病理学和临床检查结果，最终诊断为甲状腺转移性SCC。
临床上，甲状腺转移患者表现为非特异性症状，如甲状腺结节或甲状腺肿、颈部不适、呼吸困难、吞咽困难或声音嘶哑。对于多转移瘤患者采用化疗，放疗作为姑息治疗，而放射性碘治疗不适用于甲状腺转移。
诊断甲状腺中的SCC是原发性还是转移性肿瘤是一项重大挑战。在没有特定临床或放射学征象的情况下，病理研究仍然是诊断的金标准。
