J Endocr Surg.  2017 Sep;17(3):131-137. 10.16956/jes.2017.17.3.131.

Submucosal Esophageal Metastasis in a Patient with Poorly Differentiated Thyroid Carcinoma: a Case Report

• Kim MJ
• Kim CS
• Park YS
• Choi EH
• Han KD

• KMID: 2389593
• DOI: http://doi.org/10.16956/jes.2017.17.3.131

Abstract

We report an unusual case of esophageal metastasis protruding through the submucosa from a poorly differentiated thyroid carcinoma (PDTC). A PDTC is a very rare thyroid carcinoma subtype. A 68-year-old woman with PDTC exhibited recurrence at the thyroidectomy site and esophageal metastatic mass despite finishing the first treatment and undergoing regular follow-up. She received additional resective treatment with modified radical neck dissection for the recurrent neck nodes and endoscopic submucosal resection for the esophageal protruding mass. To our knowledge, no case of esophageal metastasis protruding through the submucosa from a PDTC has been previously reported.

Keyword

Thyroid neoplasms; Esophageal neoplasms; Neoplasm metastasis; Poor differentiated thyroid carcinoma; Submucosal protruding mass

MeSH Terms

Aged
Esophageal Neoplasms
Female
Follow-Up Studies
Humans
Neck
Neck Dissection
Neoplasm Metastasis*
Recurrence
Thyroid Gland*
Thyroid Neoplasms*
Thyroidectomy

Figure

• 

  Fig. 1 Pre-operative thyroid ultrasound and CT scan. Right thyroid nodule shows a small central calcification in the upper aspect (blue arrow). Left lobe showed a large 5.2-cm mixed complex type mass of the whole thyroid (white arrow). CT = computed tomography.

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  Fig. 2 (A) FNAC slide in left thyroid huge mass: intranuclear inclusions. And very few cellularity (×400). (B) FNAC slid in right thyroid mass: intranuclear inclusion (×400). (C) Insular type PDTC in left thyroid (×200). (D) Papillary thyroid carcinoma in right thyroid (×200). FNAC = fine needle aspiration cytology; PDTC = poorly differentiated thyroid carcinoma.

• 

  Fig. 3 Endoscopic evaluation of luminal protruding mass in esophagus.

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  Fig. 4 (A) Esophageal protruding mass (blue arrow). (B) Both lung metastases (blue arrows). (C, D) Post-thyroidectomy site recurrent lymph node enlargement at 18 months (white arrows).

• 

  Fig. 5 PET-CT scan. Uptake of post-thyroidectomy site recurrent lymph node (white arrow) and esophageal metastasis (blue arrows). PET = positron emission tomography; CT = computed tomography.

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