Metastatic breast cancer to thyroid gland: Case report
1 Department of Thoracic and General Surgery, Guilan University of Medical Sciences, Rasht, Iran.
2 Department of oncology, Guilan University of Medical Sciences, Rasht, Iran.,
3 Department of Pathology, Guilan University of Medical Sciences, Rasht, Iran.
4 Inflammatory Lung Diseases Research Center, Department of Internal Medicine, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
5 Department of physiology, Razi Clinical Research Development Center, Guilan University of Medical Sciences, Rasht, Iran.
Research Article
International Journal of Frontiers in Science and Technology Research, 2024, 07(01), 007–012.
Article DOI: 10.53294/ijfstr.2024.7.1.0077
Publication history:
Received on 12 April 2023; revised on 28 June 2024; accepted on 01 July 2024
Abstract:
Introduction: 1.4–3% of malignant solid tumors metastases to the thyroid gland and these events are rare. When metastatic cancers present to thyroid gland, ultrasound images mimic of the thyroid parenchyma, and diagnosis is difficult. Breast cancer rarely metastasizes to the thyroid gland.
Case: A 48-year-old woman was referred to endocrinologist clinic for enlargement of thyroid gland (goiter) with breast cancer history. Physical examination show multinodular goiter .Lymph nodes of cervical region were enlarged. Thyroid ultrasound (US) showed a multinodular goiter with maximum nodule size of 4 cm at the right thyroid lobe. This nodule was isoechoic and cystic degeneration areas with few coarse calcifications. There was a hypoechoic nodule up to 20 mm in left lobe, without any enlarged lymph nodes in the left cervical region. Thyroid and parathyroid hormone levels were normal. Cervical CT scan showed an enlarged thyroid gland and lymph nodes. An US-guided FNA was performed at the largest right and left thyroid lobe nodules, showed thyroid malignancy (Bethesda IV). The patient was monitored by US and thyroid hormone testing. Total thyroidectomy was performed. Histopathological examination revealed the presence of neoplastic infiltration of the right and left lobes with morphological and immunohystologica characteristics compatible with breast tissue origin: CK7 focally positive, CK20(-), TTFI(-)GATA-3(+),GCDFP15(-),Mammaglobin (-)PAX 8 (-),Chromogranin (-),Ki67 (15-20),ER (+),PR (+) Her -2 (-) .
Conclusion: Metastases should be rolled out in a patient with breast cancer history and thyroid gland enlargement. FNA had been performed in the larger and calcified nodule that had the most suspicious. After total thyroidectomy, primary or secondary thyroid cancer could be diagnosed according to permanent pathology and immunohistolog findings.
Keywords:
Secondary malignancy; Thyroid; Breast cancer; Metastasis.
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