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乳腺癌转移至甲状腺。

Metastasis of breast cancer to the thyroid gland.

机构信息

Unidad de Tiroides y Paratiroides del Grupo Gamma, Rosario, Santa Fe, Argentina.

Servicio de Anatomía Patológica, Hospital Español de Rosario, Rosario, Santa Fe, Argentina.

出版信息

Medicina (B Aires). 2024;84(4):741-745.

Abstract

Metastases to the thyroid gland from nonthyroidal malignant tumors are rare but significant. They are often asymptomatic, indicating advanced-stage primary tumors and poor prognosis. Although infrequently, breast cancer (BC) can metastasize to the thyroid gland. We present the case of a 56-year-old woman with a history of BC who presented with a nodular goiter. Physical examination and imaging revealed a thyroid nodule and cervical lymph nodes with suspicious features. Fine-needle aspiration biopsy (FNAB) confirmed the presence of atypical epithelial cells in the thyroid nodule and lymph nodes. Further evaluation, including positron emission tomography, histological biopsy, and immunohistochemistry, supported the diagnosis of metastatic BC to the thyroid gland. Due to the local extent of the disease, total thyroidectomy was not feasible. The treatment with ribociclib and letrozole was initiated, but unfortunately, the patient had an unfavorable progression with the development of metastasis in the nervous system. Metastatic carcinoma to the thyroid gland is rare but has increased due to improved diagnostic techniques. BC can metastasize to the thyroid. Diagnosis involves imaging, FNAB, and immunohistochemistry. Treatment options include surgery, radiotherapy, and chemotherapy, but the prognosis is generally poor.

摘要

甲状腺转移瘤来自非甲状腺恶性肿瘤,较为罕见但意义重大。这些转移瘤通常无症状,提示原发肿瘤已进展至晚期,且预后不良。虽然少见,但乳腺癌(BC)也可能转移至甲状腺。我们报告 1 例 56 岁女性,有 BC 病史,因甲状腺结节就诊。体格检查和影像学检查发现甲状腺结节和颈部淋巴结有可疑表现。细针穿刺活检(FNAB)证实甲状腺结节和淋巴结中存在不典型上皮细胞。进一步评估,包括正电子发射断层扫描、组织学活检和免疫组织化学,支持转移性 BC 累及甲状腺的诊断。由于疾病局部范围较大,无法进行全甲状腺切除术。遂开始给予瑞博西利和来曲唑治疗,但不幸的是,患者病情进展不佳,神经系统出现转移。甲状腺转移癌罕见,但由于诊断技术的提高而有所增加。BC 可转移至甲状腺。诊断包括影像学、FNAB 和免疫组织化学。治疗选择包括手术、放疗和化疗,但预后通常较差。

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