Int J Thyroidol.  2020 Nov;13(2):175-180. 10.11106/ijt.2020.13.2.175.

Thyroid Metastasis from Breast and Lung Cancer in Patients with Underlying Hashimoto’s Thyroiditis

• Im SG
• Choi H
• Im SA
• Cho SW

• KMID: 2509205
• DOI: http://doi.org/10.11106/ijt.2020.13.2.175

Abstract

Metastatic disease involving the thyroid gland is uncommon. Thyroid metastases has been previously described from several primary cancers of lung, breast, and kidney. Because of the lower incidence and ambiguous clinical significance, it is not easy to consider thyroid metastasis and decide the optimal time for performing diagnostic examination. Here, we reported two cases of metastatic diseases of thyroid in patients who had underlying Hashimoto’s thyroiditis: a 39-year-old woman who had thyroid metastasis of breast cancer with underlying Hashimoto’s thyroiditis, and a 44-year-old woman with metastatic lung cancer.

Keyword

Thyroid; Metastasis; Hashimoto’s thyroiditis

Figure

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  Fig. 1 Ultrasonographic findings of thyroid gland of Case 1 (2011-2013). Enlargement of right thyroid lobe with heterogeneous echogenicity at sonogram obtained in 2011 (A) and 2012 (B). In 2013, markedly enlarged right (C) and left (D) lobes of thyroid gland is observed with progressive changes of heterogeneous echogenicity.

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  Fig. 2 Whole body [18F] FDG PET/CT images of Case 1. Diffuse [18F]FDG uptake is observed in both thyroid glands (arrows) in 2011 (A) and 2013 (B). The maximum standardized uptake value (SUVmax) of thyroid glands is increased from 3.7 in 2011 to 4.7 in 2013. Abnormal [18F] FDG uptakes is observed at both neck in 2013 (dotted arrows). The SUVmax of right and left neck lymph nodes are 6.0 and 4.0, respectively.

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  Fig. 3 Whole body [18F] FDG PET/CT images of Case 2. (A, B) Diffuse [18F]FDG uptake is observed in both thyroid glands on [18F]FDG PET scan as an initial evaluation for lung cancer (arrows). A lung cancer lesion and mediastinal lymph node metastasis shows intense [18F]FDG uptake.

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  Fig. 4 Ultrasonographic findings of thyroid gland of Case 2. Enlargement of right (A) and left (B) thyroid lobes with heterogeneous echogenicity. Focal hypoechoic lesion is observed in right upper lobe of thyroid gland (A, arrow).

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  Fig. 5 Cytologic examination of focal thyroid lesion in Case 2. Increased cellularity (A, ×100) and atypical cells with high N/C ratio, pleomorphic nuclei and glandular pattern (B, ×400) are shown.

Reference

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