J Breast Cancer.  2018 Dec;21(4):463-467. 10.4048/jbc.2018.21.e55.

Lobular Breast Carcinoma Metastasis to the Thyroid Gland: Case Report and Literature Review

• Bourcier K
• Fermeaux V
• Leobon S
• Deluche E

• KMID: 2429826
• DOI: http://doi.org/10.4048/jbc.2018.21.e55

Abstract

Metastasis from primary cancer to the thyroid is uncommon in breast cancer. Here we present a case of lobular breast carcinoma that metastasized to the thyroid. A 54-year-old woman without symptoms was admitted to our institution for staging of the lymph node above the left clavicle. An ¹â¸F-fluoro-deoxy-D-glucose positron emission tomography scan was performed for staging, and low uptakes were observed in the left supraclavicular and cervical lymph nodes. High uptake was seen in the posterior and lower left lobe of the thyroid. Histologic findings indicated lobular breast carcinoma (positive GATA3, loss of E-cadherin expression) metastatic to the thyroid with a luminal profile. Immunohistochemical analysis was negative for primary thyroid or parathyroid carcinoma. To our knowledge, this is the first report of a patient presenting a metastatic invasive lobular carcinoma in the thyroid and lymph nodes without a prior diagnosis of breast cancer.

Keyword

Breast neoplasms; Immunohistochemistry; Lobular carcinoma; Neoplasm metastasis; Thyroid gland

MeSH Terms

Breast Neoplasms*
Breast*
Cadherins
Carcinoma, Lobular
Clavicle
Diagnosis
Female
Humans
Immunohistochemistry
Lymph Nodes
Middle Aged
Neoplasm Metastasis*
Parathyroid Neoplasms
Phenobarbital
Positron-Emission Tomography
Thyroid Gland*
Cadherins
Phenobarbital

Figure

• 

  Figure 1 18F-fluoro-deoxy-D-glucose positron emission tomography staging scan for patient with lobular breast carcinoma metastasis to the thyroid gland. (A) April 2016. (B) July 2016.

• 

  Figure 2 Histologic section from thyroid. Immunohistochemical features were presented. Infiltrating carcinoma which was made up of monomorphic cells without any glandular organization. (A) H&E-stained section of tumor. (B) Immunohistochemical positive staining for GATA3. (C) Immunohistochemical positive staining for estrogen receptor. (D) Immunohistochemical negative staining for PAX8. (E) Immunohistochemical negative staining for thyroid transcription factor 1 (A–E, ×50).

• 

  Figure 3 A decision tree to diagnose lobular breast carcinoma metastasis to the thyroid gland.TTF1=thyroid transcription factor 1.

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