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Case Reports
. 2018 Aug 6:19:920-923.
doi: 10.12659/AJCR.909349.

Thyroid Gland Hemorrhage in a Patient with Past Medical History of Renal Clear Cell Carcinoma: Report of a Very Rare Case

Ziad Abbassi  1 , Francesco Strano  1 , Evangelos Koliakos  1 , Théodoros Thomopoulos  1 , Michel Christodoulou  1
Affiliations
Case Reports

Thyroid Gland Hemorrhage in a Patient with Past Medical History of Renal Clear Cell Carcinoma: Report of a Very Rare Case

Ziad Abbassi et al. Am J Case Rep. .

Abstract

BACKGROUND The incidence of metastasis to the thyroid gland is extremely rare, with hemorrhage being a particularly uncommon manifestation of metastatic thyroid disease. CASE REPORT A 68-year-old man who underwent a right nephrectomy for RCC 8 years ago was referred to the Emergency Department (ED) complaining of upper-chest pain radiating to the left shoulder, tachycardia, and increased dysphonia. An enhanced computed tomography (CT) scan suggested a thyroid mass originating from both thyroid lobes, with right deviation of the trachea due to active bleeding. The patient underwent an emergency total thyroidectomy. The postoperative course was uneventful. The histopathological analysis of the surgical specimen revealed metastasis of an RCC. CONCLUSIONS Active bleeding of the thyroid gland is a formal indication for emergency surgical management. In patients with a history of cancer, especially in cases of RCC, metastatic disease should be suspected, although in most cases the final diagnosis can only be made after surgery.

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Conflict of interest statement

Conflict of interest: None declared

Figures

Figure 1.
Figure 1.
Intravenous contrast-enhanced CT of the abdomen. (A) Axial CT image shows a thyroid mass originating from both lobes with an intralesional vascular extravasation of contrast medium, suggesting active bleeding (1). (B) Coronal CT image shows a right deviation of the larynx and trachea caused by the mass (2). (C) Sagittal CT image shows the voluminous goiter and its plunging characteristic.
Figure 2.
Figure 2.
Histopathological images. (A) Macroscopic image of the specimen. (B) Histological section revealed metastasis of clear cell carcinoma.
See this image and copyright information in PMC

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