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Open Access Highly Accessed Case report

Solitary intrathyroidal metastasis of renal clear cell carcinoma in a toxic substernal multinodular goiter

Gianlorenzo Dionigi1*, Silvia Uccella2, Myriam Gandolfo3, Adriana Lai3, Valentina Bertocchi1, Francesca Rovera1 and Maria Laura Tanda3

Author Affiliations

1 Department of Surgical Sciences, University of Insubria, Varese, Italy

2 Human Morphology, University of Insubria, Varese, Italy

3 Clinical Medicine, University of Insubria, Varese, Italy

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Thyroid Research 2008, 1:6  doi:10.1186/1756-6614-1-6

Published: 24 October 2008

Abstract

Introduction

Thyroid gland is a rare site of clinically detectable tumor metastasis.

Case report

A 71-year-old woman was referred to our department for an evaluation of toxic multinodular substernal goiter. She had a history of renal clear cell carcinoma of the left kidney, which had been resected 2 years previously. US confirmed the multinodular goiter. Total thyroidectomy with neuromonitoring was performed on March 2008. A histological examination revealed a solitary metastasis of a clear cell renal cancer in a diffuse multinodular goiter. No distant metastases are detected.

Conclusion

Although uncommon, it is important for the endocrine surgeon and endocrine oncologist to be able to recognize and differentiate intrathyroid metastases from more primary common thyroid neoplasms. The diagnosis can be suspected if the patient has a thyroid tumor and a past history of extrathyroid cancer. These tumors, on the whole, tend to behave more aggressively and, in most cases, the use of multimodality therapy is recommended.