J Endocr Surg.  2018 Jun;18(2):167-170. 10.16956/jes.2018.18.2.167.

Thyroid Metastasis from Colon Cancer: a Case Report

• Kim DI
• Jung YJ
• Paik HJ
• Kim JY
• Kim HY

• KMID: 2420772
• DOI: http://doi.org/10.16956/jes.2018.18.2.167

Abstract

Thyroid metastasis from colon cancer is very rare and the prognosis is very poor. We present a rare case of thyroid metastasis from descending colon cancer. A 50-year-old man was visited because of palpable neck mass. He was diagnosed stage III colon cancer 51 months before symptom presentation. He has also underwent palliative chemotherapy and radiotherapy for distant metastasis of colon cancer. Imaging study showed a left side deviation of trachea due to 3.3 cm sized right thyroid gland mass which was suspicious of metastasis. The patient underwent right thyroid lobectomy. Histopathologic examination and immunohistochemistry revealed adenocarcinoma which was consistent with a diagnosis of metastases from primary colon cancer to the thyroid gland. Surgeon should consider the operation that distant metastasis to the thyroid gland is possible among the patients who present compression symptom on the neck.

Keyword

Colon cancer; Metastasis; Thyroid gland

MeSH Terms

Adenocarcinoma
Colon*
Colon, Descending
Colonic Neoplasms*
Diagnosis
Drug Therapy
Humans
Immunohistochemistry
Middle Aged
Neck
Neoplasm Metastasis*
Prognosis
Radiotherapy
Thyroid Gland*
Trachea

Figure

• 

  Fig. 1. PET/CT shows conglomerated hypermetabolic activity involving right thyroid lobe and paratracheal LNs. PET = positron emission tomography; CT = computed tomography; LN = lymph node.

• 

  Fig. 2. CT neck shows hypodense nodule at right thyroid gland with left side deviation of trachea. CT = computed tomography.

• 

  Fig. 3. (A) Metastatic tumor cell nests showed nuclear positivity for CDX2 immunostaining, (B) metastatic tumor cell nests are negative for TTF-1 immunostaining, and (C) metastatic tumor cell nests are negative for Tg immunostaining (immunohistochemical staining, ×200). TTF-1 = thyroid-transcription-factor 1; Tg = thyroglobulin.

Reference

1.Lièvre A., Leboulleux S., Boige V., Travagli JP., Dromain C., Elias D, et al. Thyroid metastases from colorectal cancer: the Institut Gustave Roussy experience. Eur J Cancer. 2006. 42:1756–9.

2.Shimaoka K., Sokal JE., Pickren JW. Metastatic neoplasms in the thyroid gland. Pathological and clinical findings. Cancer. 1962. 15:557–65.

3.Calzolari F., Sartori PV., Talarico C., Parmeggiani D., Beretta E., Pezzullo L, et al. Surgical treatment of intrathyroid metastases: preliminary results of a multicentric study. Anticancer Res. 2008. 28:2885–8.

4.Chung AY., Tran TB., Brumund KT., Weisman RA., Bouvet M. Metastases to the thyroid: a review of the literature from the last decade. Thyroid. 2012. 22:258–68.

5.Montero PH., Ibrahimpasic T., Nixon IJ., Shaha AR. Thyroid metastasectomy. J Surg Oncol. 2014. 109:36–41.

6.Froylich D., Shiloni E., Hazzan D. Metachronous colon metastasis to the thyroid: a case report and literature review. Case Rep Surg. 2013. 2013:241678.

7.Nixon IJ., Whitcher M., Glick J., Palmer FL., Shaha AR., Shah JP, et al. Surgical management of metastases to the thyroid gland. Ann Surg Oncol. 2011. 18:800–4.

8.Kumamoto K., Utsumi Y., Sugano K., Hoshino M., Suzuki S., Takenoshita S. Colon carcinoma metastasis to the thyroid gland: report of a case with a review of the literature. Tumori. 2006. 92:252–6.

9.Bong J., Cho C., Park S. Metastasis to the thyroid gland in patients with metachronous rectal carcinoma and adenocarcinoma of the lungs. J Korean Surg Soc. 2009. 76:392–7.

10.Park HS., Hong JC. A case of thyroid metastasis from pulmonary adenocarcinoma. Korean J Endocr Surg. 2011. 11:179–81.