Hadjadj S, Geoffrois L, Aubert V, Weryha G, Leclère J
Clinique médicale et endocrinologique, Hôpitaux de Brabois, Vandoeuvre.
Presse Med. 1995 Oct 14;24(30):1386-8.
Non-thyroid cancers rarely metastases to the thyroid gland. Metastases can be divided into those with clinical expression and those identified at necropsy. Symptom producing thyroid metastases are usually due to a primary renal cell cancer. We report two cases of thyroid metastasis of a clear cell renal carcinoma. In the first case, an 82-year-old woman presented with an enlarged thyroid gland. This inaugural element led to the diagnosis of thyroid metastasis and identification of recurrent renal cell carcinoma which had been treated by radiotherapy 24 years earlier. After radiotherapy for a concomitant pulmonary metastasis, the patient is in good general health with no signs of recurrence. In the second case, increased thyroid volume led to signs of compression in a 71-year-old man. The pathology report after left lobular thyroidectomy suggested trabecular adenoma or metastasis of a clear-cell primary tumour. Abdominal CT-scan revealed a 3.5 cm tumour found to be a clear-cell renal carcinoma at nephrectomy. Another osteolytic metastasis to the femur was also observed three months after surgery. The patient is in good health 15 months after the initial diagnosis. The significance of thyroid metastasis of renal cell carcinoma would vary according to the different cases reported in the literature with survival ranging from 32 months to 3-7 years after surgical exeresis. Prognosis would thus not appear to be as poor as for thyroid metastasis from other primary tumours.
非甲状腺癌很少转移至甲状腺。转移可分为有临床表现的和尸检时发现的。产生症状的甲状腺转移通常源于原发性肾细胞癌。我们报告两例透明细胞肾细胞癌甲状腺转移的病例。第一例，一名82岁女性因甲状腺肿大就诊。这一首发症状导致甲状腺转移的诊断以及复发性肾细胞癌的发现，该患者24年前曾接受放疗。在对同时出现的肺转移进行放疗后，患者总体健康状况良好，无复发迹象。第二例，一名71岁男性甲状腺体积增大导致压迫症状。左叶甲状腺切除术后的病理报告提示为小梁性腺瘤或透明细胞原发性肿瘤转移。腹部CT扫描显示一个3.5厘米的肿瘤，肾切除术后发现是透明细胞肾细胞癌。术后三个月还观察到另一处股骨溶骨性转移。初次诊断15个月后患者健康状况良好。肾细胞癌甲状腺转移的意义因文献报道的不同病例而异，手术切除后生存期从32个月到3至7年不等。因此，预后似乎不像其他原发性肿瘤的甲状腺转移那么差。
