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Case Reports
. 2008 Feb 5:6:14.
doi: 10.1186/1477-7819-6-14.

Acute airway failure secondary to thyroid metastasis from renal carcinoma

Mario Testini  1 , Germana Lissidini, Angela Gurrado, Gaetano Lastilla, Amato Stabile Ianora, Raffaele Fiorella
Affiliations
Case Reports

Acute airway failure secondary to thyroid metastasis from renal carcinoma

Mario Testini et al. World J Surg Oncol. .

Abstract

Background: Secondary involvement of the thyroid gland by malignant metastases is uncommon. Acute respiratory crisis due to infiltration of the upper airways is a recognised complication of anaplastic thyroid carcinoma or thyroid lymphoma. Renal cell carcinoma is a tumour that metastasizes diffusely and in an unpredictable manner.

Case presentation: We report a case of a 73-year-old man with a painful neck mass, dyspnoea, stridor and dysphonia that was evaluated in emergency. A right radical nephrectomy for renal cell carcinoma was performed 8 years previously. An emergency endotracheal intubation was followed by total thyroidectomy. Histological examination confirmed the diagnosis of thyroid metastasis from renal cell carcinoma.

Conclusion: A literature review regarding emergency treatment for acute respiratory compromise resulting from secondary thyroid tumours was undertaken. Only two cases of metastatic colon cancer and one case of metastatic meningioma requiring emergency thyroidectomy for acute respiratory failure are reported in the literature. This appears to be the first case of emergency surgery performed for acute respiratory compromise due to thyroid metastasis from renal cell carcinoma.

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Figures

Figure 1
Figure 1
Thyroid metastases due to renal cell carcinoma. Contrast-enhanced computed tomography scan: (A, B, C) axial images and (D) volume-rendered reconstructed image; the right lobe of the thyroid gland shows a non-homogeneous and irregular mass with tracheal involvement. The mass extends into the fatty plane in proximity to the right carotid artery and is also associated with metastatic lymph nodes.
Figure 2
Figure 2
Histological findings. A) Neoplastic cells strongly expressed CD10 antigen (Immunoperoxidase, ×200). B) Histology revealed a diffuse growth of neoplastic cells with an evident clear cytoplasm (hematoxylin and eosin, ×200).
See this image and copyright information in PMC

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