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Case Reports
. 2017 Sep 27:2017:bcr2017221296.
doi: 10.1136/bcr-2017-221296.

Unilateral adrenal mass as the sole initial manifestation of differentiated thyroid cancer

Geethalakshmi Sampathkumar  1 , Arun S Menon  1 , Bindhu M R  2 , Vasantha Nair  1
Affiliations
Case Reports

Unilateral adrenal mass as the sole initial manifestation of differentiated thyroid cancer

Geethalakshmi Sampathkumar et al. BMJ Case Rep. .

Abstract

Unilateral adrenal metastases without disseminated disease has rarely been reported in differentiated thyroid carcinoma (DTC). A 72-year-old female presented with vague abdominal discomfort and loss of appetite of 2 months duration. She had undergone left hemithyroidectomy for a benign thyroid nodule 18 years ago. A contrast CT of the abdomen showed a large left adrenal mass measuring 11×9 cm, suspicious of adrenocortical carcinoma. Hormonal evaluation was in keeping with a non-functional tumour. The patient underwent left adrenalectomy, histopathology of which revealed metastatic well-differentiated thyroid carcinoma. Ultrasound of thyroid done postoperatively showed a subcentimetric hypoechoic lesion with increased vascularity and microcalcifications in the right thyroid bed. Histopathology from a completion thyroidectomy specimen was consistent with follicular variant of papillary thyroid carcinoma. She was treated with high-dose radioiodine ablation therapy and has remained disease-free on follow-up for more than a year.

Keywords: endocrine cancer; thyroid disease.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
CT of abdomen showing the large heterodense left adrenal mass.
Figure 2
Figure 2
Histopathology of left adrenal showing the presence of metastatic thyroid carcinoma in the background of normal adrenal tissue.
Figure 3
Figure 3
High-power image of the left adrenal showing characteristic nuclear features of papillary thyroid carcinoma with follicular arrangement.
Figure 4
Figure 4
Histopathology of thyroid tissue showing follicular variant of papillary thyroid carcinoma.
Figure 5
Figure 5
Iodine 131 whole body scan 6 months after thyroidectomy showing no abnormal uptake in thyroid or adrenal gland.
See this image and copyright information in PMC

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