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Review
. 2018 Feb 6;18(1):146.
doi: 10.1186/s12885-018-4054-x.

It is no longer the time to disregard thyroid metastases from breast cancer: a case report and review of the literature

Matilde Pensabene  1 , Brigida Stanzione  2 , Ivana Cerillo  3 , Giuseppe Ciancia  4 , Immacolata Cozzolino  4 , Raffaella Ruocco  3 , Caterina Condello  3 , Giuseppe Di Lorenzo  3 , Mario Giuliano  3 , Valeria Forestieri  3 , Grazia Arpino  3 , Sabino De Placido  3 , Rossella Lauria  3
Affiliations
Review

It is no longer the time to disregard thyroid metastases from breast cancer: a case report and review of the literature

Matilde Pensabene et al. BMC Cancer. .

Abstract

Background: Metastases to the thyroid gland are more frequent than previously thought, although most of them are occult or not clinically relevant. Overall, only 42 cases of metastases to thyroid from breast cancer have been reported thus far. Here we report the case of a patient with breast cancer metastatic to the thyroid. We also review the 42 previously reported cases (published between 1962 and 2012). This is the first review about metastases to thyroid gland from breast cancer.

Case presentation: A 64-year-old woman of Caucasian origin was diagnosed with a lobular invasive carcinoma of the breast (luminal A, stage II). She received adjuvant chemotherapy, followed by endocrine therapy. During follow-up, fine-needle cytology of a thyroid nodule revealed malignant cells that were estrogen-positive, which suggested a diagnosis of metastases to the thyroid. Imaging did not reveal any other metastatic site and showed only enlargement of the left thyroid lobe and an inhomogeneous pattern of colloid and cystic degeneration and calcifications. The patient underwent left hemithyroidectomy. Histology of thyroid tissue showed a colloid goitre containing dispersed small atypical neoplastic cells with eccentric nuclei. Immunohistochemistry showed cytokeratin-19 and oestrogen receptor, but not tireoglobulin, e-cadherin or cytokeratin-7, thereby confirming metastases from a lobular breast carcinoma. Hormonal treatment is ongoing.

Conclusion: This case report and first review of the literature on metastases to thyroid from breast cancer highlight the importance of a correct early diagnostic work-up in such cases. Indeed, a primary lesion should be distinguished from metastases given the different treatment protocol related to primary cancer and the clinical impact on prognosis.

Keywords: Breast cancer; Goitre; Lobular breast cancer; Metastases to thyroid.

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Conflict of interest statement

Ethics approval and consent to participate

Not applicable.

Consent for publication

Written informed consent was obtained from the patient for the publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
a Cytology of thyroid metastases and plasmacytoid-like aspect (inset). b Immunocytochemistry with positive estrogen receptor staining. c Histology of thyroid metastases
Fig. 2
Fig. 2
Immunohistochemistry showing cytokeratin 19 (a) and estrogen receptor (b)
Fig. 3
Fig. 3
Diagnostic work-up and treatment of patient with thyroid metastases from breast cancer
See this image and copyright information in PMC

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