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Case Reports
. 2020:66:39-42.
doi: 10.1016/j.ijscr.2019.11.013. Epub 2019 Nov 18.

Rectal cancer with a metastasis to the thyroid gland: A case report

Katsusuke Mori  1 , Koji Koinuma  2 , Hiroshi Nishino  3 , Hisanaga Horie  1 , Alan Kawarai Lefor  1 , Naohiro Sata  1
Affiliations
Case Reports

Rectal cancer with a metastasis to the thyroid gland: A case report

Katsusuke Mori et al. Int J Surg Case Rep. 2020.

Abstract

Introduction: Metastases to the thyroid gland in patients with colorectal cancer are uncommon. We report a patient with rectal cancer who developed a metastasis to the thyroid gland.

Presentation of case: The patient was a 45-year-old female five years status post rectal cancer resection. A thyroid lesion was detected on PET-CT scan with synchronous lung metastases. After pulmonary resection, a partial thyroidectomy was performed and pathological examination with immunohistochemical staining confirmed that the lesion was a metastasis from previous rectal cancer. She is free from recurrence two years after thyroid surgery.

Discussion: Colorectal metastases to the thyroid gland are usually seen with widespread disease, often with lung and liver metastases. The overall outcomes of previously reported patients with thyroid metastases were extremely poor, with most patients dying within months of diagnosis. Careful attention should be given to other sites of metastatic disease including the thyroid gland during postoperative follow-up. PET scan may be helpful to establish the diagnosis.

Conclusion: Treatment decisions must be individualized, and depend on the presence of systemic disease. Selected patients may benefit from resection of metastases, and PET scan may be useful to identify patients who will benefit from resection.

Keywords: Case report; Colorectal cancer; Thyroid metastasis.

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Conflict of interest statement

Declaration of Competing Interest All authors have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Abnormal uptake areas of fluoro-2 deoxy-D-glucose are seen in the right lobe of the thyroid gland (A) and right lower lung (B) on positron emission tomography – computed tomography imaging.
Fig. 2
Fig. 2
A 12 mm mass is seen in the right lower thyroid lobe with ultrasonography.
Fig. 3
Fig. 3
A yellowish thyroid tumor is seen in the resected specimen.
Fig. 4
Fig. 4
Pathology of the primary rectal cancer (A; ×100, B; ×400, H&E) and thyroid tumor (C; ×100, D; ×400, H&E).
Fig. 5
Fig. 5
Immunohistochemical examination shows the thyroid tumor to be positive for CK20 (A; ×100), CDX-2 (B; ×100), and negative for CK7 (C; ×100), TTF (D; ×100).
See this image and copyright information in PMC

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