Liu Chunjiao, Ma Haifen, Xiao Weihua, Li Junqiang, Jiang Maofen, Sheng Jingdan
Department of Pathology, Beilun District People's Hospital of Ningbo City, Ningbo, Zhejiang 315000, P.R. China.
Oncol Lett. 2024 Dec 18;29(3):105. doi: 10.3892/ol.2024.14851. eCollection 2025 Mar.
Renal cell carcinoma (RCC) is the most common malignancy that metastasizes to the thyroid; however, metastasis of RCC to a primary tumor of the thyroid is rare. The present study reports the case of RCC that had metastasized to the primary thyroid tumor; namely, a hyalinizing trabecular tumor (HTT). Notably, the RCC was resected 2 years prior. A 60-year-old female patient was referred to Ningbo Beilun District People's Hospital with radiographic findings indicating thyroid nodules. The patient's previous medical history included a left nephrectomy for the treatment of clear cell (cc)RCC in February 2021. No other distant metastases were identified as of the latest follow-up in April 2023. No abnormalities were observed during thyroid function tests prior to thyroid surgery. The surgical specimen appeared as a multinodular goiter with a solid nodule measuring 55×41×33 mm on the left lobe of the thyroid. Microscopic examination revealed a gray-yellow area inside the capsule of the largest nodule of the left lobe, which was composed of clear cells arranged in a solid pattern. Notably, tumor cells in other areas exhibited trabecular, nested and island patterns. Results of an immunohistochemical examination revealed that the clear cell lesion was negative for thyroid transcription factor-1 and calcitonin, and strongly positive for carbonic anhydrase IX, common acute lymphoblastic leukemia antigen and vimentin. To the best of our knowledge, the present study is the first to report a case of ccRCC that had metastasized to a HTT. A preliminary analysis of the potential mechanisms underlying ccRCC metastasis was performed. Following total thyroidectomy, the patient was treated with levothyroxine, underwent anti-programmed death-1 monoclonal antibody immunotherapy and small molecule tyrosine kinase inhibitor targeted therapy. An enhanced computed tomography scan revealed no evidence of metastatic disease to other organs. As of the latest follow-up, the patient was in a good condition with no sign of metastasis or recurrence.
肾细胞癌（RCC）是最常见转移至甲状腺的恶性肿瘤；然而，RCC转移至原发性甲状腺肿瘤却很罕见。本研究报告了1例转移至原发性甲状腺肿瘤（即透明变梁状肿瘤[HTT]）的RCC病例。值得注意的是，该RCC在2年前已被切除。一名60岁女性患者因影像学检查发现甲状腺结节被转诊至宁波市北仑区人民医院。患者既往病史包括2021年2月因治疗透明细胞（cc）RCC行左肾切除术。截至2023年4月的最新随访，未发现其他远处转移。甲状腺手术前甲状腺功能检查未发现异常。手术标本表现为多结节性甲状腺肿，甲状腺左叶有一个55×41×33 mm的实性结节。显微镜检查显示左叶最大结节的包膜内有一个灰黄色区域，由呈实性排列的透明细胞组成。值得注意的是，其他区域的肿瘤细胞呈梁状、巢状和岛状排列。免疫组化检查结果显示，透明细胞病变甲状腺转录因子-1和降钙素阴性，碳酸酐酶IX、普通急性淋巴细胞白血病抗原和波形蛋白强阳性。据我们所知，本研究首次报告了1例转移至HTT的ccRCC病例。对ccRCC转移的潜在机制进行了初步分析。全甲状腺切除术后，患者接受左甲状腺素治疗，接受抗程序性死亡-1单克隆抗体免疫治疗和小分子酪氨酸激酶抑制剂靶向治疗。增强计算机断层扫描显示无其他器官转移疾病的证据。截至最新随访，患者情况良好，无转移或复发迹象。
