Chonnam Med J.  2011 Aug;47(2):130-133. 10.4068/cmj.2011.47.2.130.

A Case of Metastatic Renal Cell Carcinoma to Thyroid Gland

• Lee JG
• Yang Y
• Kim KS
• Hyun CL
• Lee JS
• Koh G
• Lee D

• KMID: 2048799
• DOI: http://doi.org/10.4068/cmj.2011.47.2.130

Abstract

Metastasis to the thyroid gland from distant cancer is rare, and, in some cases, is a diagnostic challenge. Here, we report a case of metastatic renal cell carcinoma of the thyroid gland. A 77-year-old man presented with a neck mass detected about 1 month previously. He had undergone a right nephrectomy owing to renal cell carcinoma 14 years previously. Fine needle aspiration cytology showed a few atypical follicular cells with nuclear atypia. Under a tentative diagnosis of papillary thyroid carcinoma, a total thyroidectomy was performed. The histologic and immunohistochemical studies of the surgical specimens indicated that the thyroid masses were metastatic renal cell carcinoma to the thyroid.

Keyword

Metastasis; Renal cell carcinoma; Thyroid cancer

MeSH Terms

Aged
Biopsy, Fine-Needle
Carcinoma
Carcinoma, Renal Cell
Humans
Neck
Neoplasm Metastasis
Nephrectomy
Thyroid Gland
Thyroid Neoplasms
Thyroidectomy
Carcinoma
Thyroid Neoplasms

Figure

• 

  FIG. 1 CT scan of the neck showed two large cystic and degenerating thyroid masses. The mass on the left thyroid gland was a 7.2×5.5 cm sized mass with severe necrosis. The mass on right thyroid was a 3.8×3.8 cm sized well-circumscribed mass. There was no lymph node metastasis. (A) Axial view. (B) Coronal view.

• 

  FIG. 2 Macro- and microscopic findings of renal cell carcinoma metastasis in the thyroid. (A) On gross inspection of the resected specimen, there were well demarcated masses with cystic change and hemorrhage in both lobes of the thyroid gland. Characteristic histologic appearance is shown with small nests of clear cells separated by a prominent sinusoidal network (B, H&E stain, ×100) with abundant optically empty cytoplasm, sharply outlined boundaries, and moderately atypical nuclei (C, H&E stain, ×200). These microscopic findings were identical to those of the previously resected primary renal cell carcinoma, clear cell type (D, H&E stain, ×200).

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  FIG. 3 Immunohistochemical staining of renal cell carcinoma metastasis to the thyroid. The tumor cells characteristically expressed cytokeratin (A), vimentin (B), CD10 (C), and epithelial membrane antigen (D), but did not express thyroglobulin (E) or thyroid transcription factor-1 (F) (avidin-biotin-peroxidase, ×200).

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