Endocrinol Metab.  2010 Dec;25(4):370-373. 10.3803/EnM.2010.25.4.370.

Thyroid Dysfunction Induced by Metastatic Thyroid Cancer: Report of Two Cases

• Ahn KH
• Choi BK
• Kim WJ
• Choi BG
• Jeon YK
• Kim SS
• Lee SH
• Kim BH
• Kim YK
• Kim IJ

• KMID: 1497765
• DOI: http://doi.org/10.3803/EnM.2010.25.4.370

Abstract

Metastases to the thyroid gland are not frequently observed in clinical practice, although an overall incidence of secondary thyroid malignant tumors has been reported to range from 1.25% to 24% in autopsy series. Generally, patients with metastatic thyroid cancer present with euthyroidism and they do not develop thyroid dysfunction. Thyroid dysfunctions, including hypothyroidism and hyperthyroidism, rarely occur in patients with metastatic thyroid cancer. We describe here a case of hypothyroidism induced by thyroid metastasis from cancer of an unknown primary site in a 53-year-old man and another case of thyrotoxicosis induced by thyroid metastasis from lung cancer in a 65-year-old man.

Keyword

Hypothyroidism; Thyroid neoplasms; Thyrotoxicosis

MeSH Terms

Aged
Autopsy
Humans
Hyperthyroidism
Hypothyroidism
Incidence
Lung Neoplasms
Middle Aged
Neoplasm Metastasis
Thyroid Gland
Thyroid Neoplasms
Thyrotoxicosis

Figure

• 

  Fig. 1 (A) Ultrasonographic findings. Both lobes of the thyroid gland are enlarged with the heterogeneous echogenicity of the parenchyma and scattered hypoechoic areas. (B) Color Doppler shows that blood flow is slightly decreased in the parenchyma of both glands.

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  Fig. 2 (A) TcO4-99m thyroid scan. The thyroid gland is poorly visualized. (B) F(18)-FDG PET/CT image demonstrates increased FDG uptake (maxSUV: right, 5.4; left, 5.1) in the thyroid gland and paratracheal LN (maxSUV: 4.7).

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  Fig. 3 Histologic findings. (A) Cytologic examination of fine needle aspirates from the thyroid gland reveals adenocarcinoma, most likely metastatic, with frequent papillary growth (H&E, × 200). (B) Cytologic examination of fine needle aspirates from the thyroid gland exhibits squamous cell carcinoma (H&E, × 400).

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  Fig. 4 (A) TcO4-99m thyroid scan. Both lobes of the thyroid gland have a cold space occupying lesion (SOL). (B) Ultrasonographic findings. Diffuse and focal hypoechogenicities are seen on both lobes.

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