Category: Thyroid

Monitor: 22

22 - THYROID METASTASIS FROM UTERINE PAPILLARY SEROUS CARCINOMA: A RARE OCCURENCE

Saturday, Apr 27
10:00 AM – 10:30 AM

Objective :

Cancer metastasis to the thyroid gland is a very rare phenomenon. Tumors that lead to secondary involvement of the thyroid include malignant neoplasms of the kidney, breast, colorectal, lung and head/neck region. Metastasis from uterine cancer constitutes about 1.3-4% of all the malignancies affecting the thyroid gland.
We are reporting a case of thyroid metastasis from a uterine papillary serous carcinoma in a 71-year-old woman, who presented to us with goiter and dysphagia. 


Methods : .


Results : Our patient is a 71-year-old female with a medical history significant for remote breast cancer-status post bilateral mastectomy in 1998 and uterine papillary serous carcinoma (Grade-1 UPSC)- status post chemotherapy, vaginal brachytherapy and total abdominal hysterectomy with bilateral salpingo-oophorectomy, bilateral pelvic node dissection, omentectomy, and retroperitoneal space dissection 4 years prior to presentation. She complained of dysphagia and neck swelling for about six months. On examination, she had a multinodular goiter that moved upwards with swallowing. On thyroid ultrasound, the right thyroid lobe measured 4.7 x 1.9 x 1.8 cm and the left thyroid lobe 6.1 x 1.8 x 1.7 cm.  Multiple hypoechoic solid-appearing nodules were noted within the thyroid gland bilaterally. Labs showed TSH of 1.46 (Normal 0.5-6 uU/ml), free T3 of 2.68 (Normal 2.4- 4.2 pg/mL) and free T4 of 1.19 (Normal 0.8-1.8 ng/dL). A fine needle biopsy was performed and histopathology showed neoplastic cells with no colloid in the background. A diagnosis of metastatic uterine papillary serous cancer was made and the patient underwent radiotherapy with significant relief of symptoms


Discussion : Malignancies of the thyroid gland - both primary and secondary are a rare diagnosis. Primary thyroid cancer comprises 1% of all cancers in the United States. To our knowledge, this is the first case report of uterine papillary serous carcinoma metastasizing to the thyroid gland.


Conclusion : Local and distant metastases are a major problem with uterine cancer even after surgical intervention. Although the thyroid is not a commonly involved, it is important to maintain a high index of suspicion for this association in a patient with a history of uterine cancer presenting with dysphagia, goiter and/or hoarseness of voice.

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Syeda Naqvi

Physician
Presence health
Chicago, Illinois

Currently working as a first year resident at Presence Saint Joseph Hospital. Interested in the field of Endocrinology

Thomas J. Varghese

Resident Physician
Saint Joseph Hospital Chicago
chicago, Illinois

I am currently a third year resident in internal medicine at Chicago interested in Endocrinology and Oncology.

Faisal J. Qureshi

Chief Section of Endocrinology
Presence Saint Joseph Hospital Chicago
chicago

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faisal qureshi