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肾细胞癌甲状腺转移表现为实性肿块并迅速增大。

Thyroid metastasis from renal cell carcinoma presenting as a solid mass with rapid enlargement.

作者信息

Chiardi Isabella, Gaffuri Priska, Leoncini Andrea, Trimboli Pierpaolo

机构信息

Thyroid Unit of Clinic for Endocrinology and Diabetology, Lugano Regional Hospital, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.

Faculty of Medicine and Surgery, Humanitas University, Rozzano, Milan, Italy.

出版信息

Endocrinol Diabetes Metab Case Rep. 2024 Jan 31;2024(1). doi: 10.1530/EDM-23-0126. Print 2024 Jan 1.

Abstract

SUMMARY

Thyroid metastases from nonthyroidal malignancies (NTMs) represent a diagnostic challenge, often displaying heterogeneous clinical manifestations. These metastases are rare but significant, accounting for approximately 2% of thyroid malignancies. Distinguishing them from primary thyroid malignancies is challenging due to the lack of specific ultrasound features, and the ultrasound-based risk stratification systems offer limited utility in such cases. Fine needle aspiration cytology is crucial for definitive diagnosis, yet it may not always provide accurate results. In this case report, we describe a unique instance of thyroid metastases originating from renal cell carcinoma, emphasizing the complexities in diagnosis and the importance of considering oncological conditions when assessing thyroid masses. Awareness of thyroid metastasis from NTMs, particularly in cases of diffuse thyroid hypoechogenicity and hypothyroidism, is essential for clinicians in their diagnostic approach.

LEARNING POINTS

Thyroid metastases from nonthyroidal malignancies are diagnostic challenges due to their heterogeneous clinical presentations, often mimicking primary thyroid malignancies. Thyroid metastases from nonthyroidal malignancies are relatively rare, but they still account for approximately 2% of thyroid malignancies. It is fundamental to consider oncological conditions when assessing thyroid masses, especially in cases of diffuse thyroid hypoechogenicity, hypothyroidism, and history of other tumors. Thyroid presentation is quite similar to that of autoimmune hypothyroidism, endocrinologists must be aware of the possibility of thyroid hypofunction due to the massive invasion of the parenchyma.

摘要

摘要

非甲状腺恶性肿瘤(NTM)的甲状腺转移瘤是一个诊断难题,临床表现往往具有异质性。这些转移瘤虽罕见但意义重大,约占甲状腺恶性肿瘤的2%。由于缺乏特异性超声特征,将它们与原发性甲状腺恶性肿瘤区分开来具有挑战性,基于超声的风险分层系统在此类病例中的效用有限。细针穿刺细胞学检查对明确诊断至关重要,但可能并非总能提供准确结果。在本病例报告中,我们描述了一例源自肾细胞癌的甲状腺转移瘤的独特病例,强调了诊断的复杂性以及在评估甲状腺肿块时考虑肿瘤情况的重要性。临床医生在诊断过程中,认识到NTM的甲状腺转移瘤,尤其是在甲状腺弥漫性低回声和甲状腺功能减退的情况下,至关重要。

学习要点

非甲状腺恶性肿瘤的甲状腺转移瘤因其临床表现异质性,常与原发性甲状腺恶性肿瘤相似,是诊断难题。非甲状腺恶性肿瘤的甲状腺转移瘤相对罕见,但仍约占甲状腺恶性肿瘤的2%。评估甲状腺肿块时,考虑肿瘤情况至关重要,尤其是在甲状腺弥漫性低回声、甲状腺功能减退以及有其他肿瘤病史的情况下。甲状腺表现与自身免疫性甲状腺功能减退非常相似,内分泌科医生必须意识到由于实质大量受侵导致甲状腺功能减退的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cbce/10895323/d4978d73ada0/EDM23-0126fig1.jpg

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