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Case Reports
. 2016 Dec 25:81:618-621.
doi: 10.12659/PJR.899459. eCollection 2016.

Metastasis of Renal Clear Cell Carcinoma to Thyroid Gland Mimicking Adenomatous Goiter

Atilla Hikmet Cilengir  1 , Tugce Ozlem Kalayci  1 , Gokhan Duygulu  1 , Turkan Atasever Rezanko  2 , Mehmet Fatih İnci  1
Affiliations
Case Reports

Metastasis of Renal Clear Cell Carcinoma to Thyroid Gland Mimicking Adenomatous Goiter

Atilla Hikmet Cilengir et al. Pol J Radiol. .

Abstract

Background: Renal cell carcinoma is an interesting tumor due to its unpredictable behavior. Common metastatic sites of renal cell carcinoma are the lungs, lymph nodes, bones and liver. Concurrent thyroid metastasis of clear cell carcinoma is uncommon but it can appear as a rapidly growing cervical, painless nodular mass.

Case report: We report a case of a 56-year-old male patient with clear cell renal carcinoma confirmed on a histopathological examination. The patient noticed a rapidly growing mass in the thyroid region when receiving medical anticancer therapy. Because of that, gray-scale thyroid ultrasonography and a fine-needle aspiration biopsy were performed. The histopathological examinationof the biopsy specimen revealed a lesion composed of malignant epithelial cells compatible with metastasis of renal carcinoma.

Conclusions: In patients with with a history of RCC, both past and present, a thyroid mass, especially co-existing with an adenomatous goiter, should prompt a work-up for thyroid metastasis.

Keywords: Carcinoma, Renal Cell; Goiter; Neoplasm Metastasis; Thyroid Nodule.

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Conflict of interest statement

statement The authors of this paper have no conflicts of interest, including specific financial interests, relationships and affiliations relevant to the subject matter or materials included.

Figures

Figure 1
Figure 1
(A) Coronal abdominal magnetic resonance imaging. Post-contrast T1-weighted imaging (WI) demonstrated a mass originating from the middle and lower zone of the left kidney (arrows), with irregular contours and 83×97 mm in size. The mass enhanced post-contrast except for necrotic areas (arrow head) similarly to another mass in the right adrenal with heterogeneous enhancement (dashed arrow). (B) On T2WI, the central area of the mass is hyperintense due to necrosis (arrow head). Another mass in the right adrenal gland (arrows), 48×76 mm in size, whose signal characteristics are similar to those of the renal mass.
Figure 2
Figure 2
(A) Clear cell RCC; Fuhrman nuclear grade 2 (left side) and 4 (right side) (Nephrectomy specimen, Haematoxylin & Eosin ×40, ×200). (B) Fine needle aspiration biopsy from the thyroid nodule; atypical epithelial cells with abundant clear or vacuolated cytoplasm, vesicular nucleui and concipious nuclei in the background of scant or no colloid (MGG left side, PAP right side ×400). (C) Cell block preparation; tumoral cells showed positive immunostaining for Vimentin, Pax8 and EMA.
Figure 3
Figure 3
Ultrasound imaging showed a hypoechoic, nodular, solid mass in the thyroid gland, 30×22 mm in size, with microcalcifications and macrolobulated contours.
See this image and copyright information in PMC

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