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Chirurgia 2012 December;25(6):457-60


language: English

A 92-year-old woman with solitary metastasis to the thyroid gland 6 years after nephrectomy for renal cell carcinoma

Shimizu J. 1, Kamesui T. 1, Moriya M. 1, Murata T. 2, Nagano K. 3, Minato H. 4

1 Department of Surgery, Hokuriku Central Hospital, Oyabe, Japan; 2 Department of Surgery, Ishikawa Prefectural Central Hospital, Kanazawa, Japan; 3 Department of Urology, Public Central Hospital of Matto Ishikawa, Hakusan, Japan; 4 Department of Pathology and Laboratory Medicine, Kanazawa Medical University, Kahoku-gun, Japan


A 92-year-old woman presented to her local physician with pressure sensation in the neck and was found to have a mass on the left side of the neck. She had a history of undergoing left nephrectomy for carcinoma of the left kidney at the age of 86 years. Computed tomography (CT) scan and ultrasonography of the neck revealed a well-circumscribed heterogeneous mass in the lower pole of the left lobe of the thyroid gland measuring 21×17 mm in size. The result of fine-needle aspiration cytology of the mass was class II. Based on these findings, adenomatous goiter was suspected, however, malignancy could not be excluded. Thus, surgery was performed for definitive diagnosis and treatment. A well-circumscribed, elastic hard mass was found in the lower pole of the left lobe of the thyroid gland. No infiltration to surrounding tissues was observed and the left thyroid lobe was resected. Histopathological examination of the resected specimen revealed that the tumor was mostly composed of atypical clear cells with an alveolar growth pattern, leading to a suspicion of a thyroid metastasis from renal cell carcinoma. Immunohistochemical staining of the tumor revealed positive staining for CD10 and epithelial membrane antigen and a negative result for cytokeratin 7, thyroid transcription factor-1 and thyroglobulin. Thus, a thyroid metastasis from renal cell carcinoma was definitely diagnosed. It is known that metastases from renal cell carcinoma can be of a slow-growing type, that can manifest years after resection of the primary lesion in some cases. We report this rare case of solitary metastasis from renal cell carcinoma to the thyroid gland.

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