Ro J Y, Guerrieri C, el-Naggar A K, Ordóñez N G, Sorge J G, Ayala A G
Department of Pathology, University of Texas M. D. Anderson Cancer Center, Houston 77030.
Arch Pathol Lab Med. 1994 May;118(5):551-6.
Metastases to the thyroid gland are an uncommon occurrence, and metastasis to a preexisting thyroid neoplasm is even more rare. We report two cases of tumor-to-tumor metastasis where a prostatic and a breast carcinoma metastasized to follicular adenoma of the thyroid gland. The metastatic process in case 1 was initially diagnosed by fine-needle aspiration biopsy and later confirmed with the hemithyroidectomy. Immunostaining for prostate-specific antigen and prostatic acid phosphatase in case 1 and estrogen and progesterone receptors in case 2 demonstrated strong immunoreactivity in the metastatic tumor cells. Flow cytometric DNA analysis of the primary and the metastatic tumors in both cases demonstrated stemline fidelity that supported their association. Our cases exemplify why attention should be given to the possibility of metastasis when distinctly different morphologic features are seen in an otherwise typical tumor and the utility of ancillary tests that may assist in establishing the diagnosis.
甲状腺转移瘤并不常见，转移至已存在的甲状腺肿瘤则更为罕见。我们报告两例肿瘤至肿瘤转移的病例，其中前列腺癌和乳腺癌转移至甲状腺滤泡性腺瘤。病例1的转移过程最初通过细针穿刺活检诊断，随后通过甲状腺半切除术得以证实。病例1中前列腺特异性抗原和前列腺酸性磷酸酶的免疫染色以及病例2中雌激素和孕激素受体的免疫染色显示转移瘤细胞有强免疫反应性。两例病例中原发肿瘤和转移肿瘤的流式细胞术DNA分析均显示干系一致性，支持它们之间的关联。我们的病例例证了为何当在原本典型的肿瘤中见到明显不同的形态学特征时应注意转移的可能性，以及辅助检查在协助确立诊断方面的作用。
