Abstract
An 80-year-old female, who had undergone total thyroidectomy and bilateral modified neck dissection after a diagnosis of thyroid papillary carcinoma with neck lymphnode metastasis, was revealed through a post-operative chest CT examination to have a lung mass instead of old pulmonary tuberculosis. The diagnosis of lung adenocarcinoma was made by a percutaneous needle biopsy. The patient expired five months after the thyroid operation without undergoing any intensive treatment, partly because of her age. The final diagnosis determined by autopsy was primary lung carcinoma metastatising to the thyroid gland and to the neck lymphnodes.
According to information collected from 57 reported cases in Japan, primary lesions involving thyroid metastasis can be broken down as follows: kidney in 21 cases, lung in 7 cases, stomach in 6 cases, breast in 5 cases, esophagus in 4 cases, rectum in 3 cases; and the skin, uterus, ovary, villus, thymus, pancreas, larynx and an unknown location in one case each.
The absence of calcification, as well as a rapid growth and a significant increase in the tumor marker in the serum are findings which suggest metastatic thyroid carcinoma. The prognosis for patients with metastatic thyroid carcinoma is generally poor. However, long survivals after radical thyroid surgery have been reported in the literature. Thus, treatment modality should be individualized according to the patient's status and the tumor's grade and degree of extension.
