Abstract YO39
Case summary
Background: Follicular thyroid carcinoma commonly presents with hematogenous metastasis to the lung and bone and rarely to the kidney. We report a case of a 61-year old woman with a metastatic follicular thyroid carcinoma to the kidney. This case report shows how a systematic approach on a patient with a renal mass can lead to a diagnosis of an unexpected primary cancer.
Case Report: A 61-year old female presented with progressively enlarging back mass. Whole abdominal ultrasound revealed right renal mass; chest CT scan showed multiple heterogeneously varisized pulmonary nodules. Ct-guided fine needle aspiration biopsy of the lung nodule was compatible with a non-small cell carcinoma. Immuno-histochemistry was positive for CK7, TTF1 and thyroglobulin and CK 20 negative favoring metastatic thyroid carcinoma. Ultrasound-guided core needle biopsy of the renal mass was compatible with thyroid carcinoma, metastatic (thyroglobulin positive). The final histopathology report after thyroidectomy was non-invasive follicular thyroid neoplasm with papillary-like nuclear features. The patient received radioactive iodine and is now with better quality of life.
Discussion: Metastatic follicular thyroid carcinoma is a rare phenomenon with only 25 cases reported in the English literature to date. Johnson et al in 1982 reported a case of follicular thyroid carcinoma with metastasis to the kidney 37 years after resection of the primary tumor. In a study by Parameswaran in 2016 on patterns of metastasis in follicular thyroid carcinoma, they found out that 40% of cases metastasized at a median of 4.5 years after initial thyroidectomy, lungs being the most common site followed by bone (25%), regional lymph nodes (13%) and brain (12%). None of the said cohort had metastasis to the kidney. The best management of FTC presenting as metastatic disease should be managed aggressively with total thyroidectomy followed by RAI which was done in our patient.
Conclusion: Given the rarity of thyroid metastasis to the kidney, a diagnostic dilemma for this case was a challenge. This case provides new data to clinicians that thyroid carcinoma can metastasize to the kidney and may mimic renal cell carcinoma although rarely reported.
Clinical trial identification
Editorial acknowledgement
Resources from the same session
107P - The efficacy of adjuvant chemotherapy according to the risk classification of recurrence based on the systemic inflammatory markers in patients with colorectal cancer liver metastases
Presenter: Masatsune Shibutani
Session: Poster display session
Resources:
Abstract
108P - Influence of liver metastasis locations on overall survival in patients with colorectal cancer
Presenter: Takayuki Sone
Session: Poster display session
Resources:
Abstract
109P - 18F-FDG PET/CT textural features as predictors of outcomes in patients with primary advanced colorectal cancer
Presenter: Jing Yang
Session: Poster display session
Resources:
Abstract
110P - D3 lymph node dissection may be necessary in clinical stage I right colon cancer
Presenter: Woong Bae Ji
Session: Poster display session
Resources:
Abstract
111P - Is preoperative chemoradiotherapy necessary for all patients with upper rectal cancer: One center retrospective study
Presenter: Jasur Madyarov
Session: Poster display session
Resources:
Abstract
112P - A retrospective analysis of the association between perioperative, post adjuvant carcinoembryonic antigen level and prognosis in stage III colorectal cancer
Presenter: Ryotaro Kozuki
Session: Poster display session
Resources:
Abstract
113P - Dicer contributes to chemoresistance in colorectal cancer via regulating a set of miRNAs and their downstream mRNAs
Presenter: Liang-Yi Hung
Session: Poster display session
Resources:
Abstract
114P - Efficacy and safety of the combination of bevacizumab with raltitrexed-based chemotherapy as second-line therapy in patients with metastatic colorectal cancer (mCRC): An interim analysis of a multicenter phase II trial
Presenter: Jun Zhu
Session: Poster display session
Resources:
Abstract
115P - Expression of Ki-67 as a prognostic factor in patients with colorectal cancer
Presenter: Kuantkan Zhabagin
Session: Poster display session
Resources:
Abstract
116P - Clinical significance and converionrate relevance of RAS genetic mutation analysis for unresectable colorectal liver metastases: A single-center retrospective study
Presenter: Meiling Ji
Session: Poster display session
Resources:
Abstract