A Case Report of Metastatic Renal Cell Carcinoma to the Thyroid Gland in a Patient with a Non-recurrent Inferior Laryngeal Nerve Associated with a Right Aberrant Subclavian Artery

Abstract

A man in his 60s had undergone left nephrectomy for renal cell carcinoma (RCC) 14 years ago. After two partial pneumonectomies for lung metastases performed 4 and 6 years ago, the patient had remained under regular follow-up. He was referred to our surgical department with the chief complaint of a neck mass. Ultrasonography showed some swelling of the cervical lymph nodes and a thyroid tumor occupying the left lobe. Fine-needle aspiration of both masses revealed metastatic RCC. CT showed a right aberrant subclavian artery. Total thyroidectomy and lymphadenectomy were performed. A non-recurrent inferior laryngeal nerve (NRILN) arising directly from the right cervical vagus was observed and preserved during the operation. Pathological studies established the diagnosis of metastatic RCC to the thyroid gland. A NRILN must be anticipated when a right aberrant subclavian artery is diagnosed preoperatively. When a patient with a previous history of RCC presents with some symptoms, imaging examinations are necessary owing to the possibility of delayed metastasis.