J Korean Med Sci.  2009 Dec;24(6):1230-1233. 10.3346/jkms.2009.24.6.1230.

A Case of Thyroid Metastasis Originating from Early Gastric Cancer

• Ihn MH
• Kim YJ
• Kim JJ
• Cho JY
• Jin SY

• KMID: 1783164
• DOI: http://doi.org/10.3346/jkms.2009.24.6.1230

Abstract

We report a rare case of thyroid metastasis from early gastric cancer with lymph node metastasis in a 63-yr old woman. She was diagnosed with metastatic adenocarcinoma one and a half years after distal subtotal gastrectomy, by fine needle aspiration (FNA) using thyroid sonography. Thyroid metastasis from gastric cancer is extremely rare, and this case is particular in that it is the first report of thyroid metastasis from early gastric cancer.

Keyword

Stomach Neoplasms; Thyroid Metastasis; Lymph Node Metastasis

MeSH Terms

*Adenocarcinoma/pathology/secondary
Biopsy, Fine-Needle
Fatal Outcome
Female
Humans
Lymphatic Metastasis/*pathology
Middle Aged
Stomach Neoplasms/*pathology
Thyroid Neoplasms/pathology/*secondary

Figure

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  Fig. 1 Macroscopic finding of the resected stomach. An irregular ulceroinfiltrative lesion is noted at the pylorus on the lesser curvature side, measuring 2.0 cm in diameter.

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  Fig. 2 Microscopic findings of the resected stomach. (A) Diffuse proliferation of tumor cells are noted without gland formation (H&E, ×40). (B) Each tumor cell is signet ring in shape and their nuclei are displaced eccentrically by intracytoplasmic mucin vacuoles (H&E, ×400).

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  Fig. 3 Abdominal computed tomography findings one and half years after gastrectomy. There are newly developed multiple paraaortic lymph node enlargement.

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  Fig. 4 Thyroid sonogram shows diffuse nodular enlargement of both lobes.

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  Fig. 5 Microscopic findings of needle biopsy specimen of the thyroid metastasis. (A) Normal thyroid follicles are destroyed by dispersed tumor cells (H&E, ×40). (B) Atypical signet ring cells identical to the gastric cancer are noted (H&E, ×400). Immunohistochemistry demonstrates positive staining for carcinoembryonic antigen (C) and negative for thyroglobulin (D) (C&D: avidin biotin complex method, ×400).

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