Canan UZEL, Halil COŞKUN, Tarık TERZİOĞLU, Necdet ARAS

Radikal nefrektomiden sekiz yıl sonra renal hücreli karsinomdan tiroit metastazı: Olgu sunumu

Sekiz yıl önce sağ renal hücreli karsinom tanısıyla radikal nefrektomi yapılan T2N0M0grade 2, berrak hücreli subtip 45 yaflında kadın hastada tiroitte no- dül saptandı. Boyun ultrasonografisinde multipl hi- poekoik makronodüler yapı görüldü, lenfadenoma- galiye rastlanmadı. Multinodüler guatr düflünülerek yapılan total tiroidektomi sırasında, frozen ile ince- lenen örnekte renal hücreli karsinom metastazı saptandı. İmmünhistokimyasal analizde, tiroit tü- möründeki berrak hücreler tiroglobulin için boyama göstermedi. Ameliyat sonrasında hastanın 12 aylık izleminde nüks veya baflka metastatik hastalığa rastlanmadı. Tiroit bezinde metastaz çok nadir olsa da, renal hücreli karsinom öyküsü olan hastalarda tiroide metastaz olabileceği göz önünde bulunduru l malıdır

Anahtar Kelimeler:

Karsinom/ikincil, karsinom, renal hücreli/ikincil/patoloji, böbrek neoplazileri/patoloji, tiroit neoplazileri/ikincil/cerrahi, tiroidektomi

Thyroid metastasis from renal celi carcinoma eight years after radical nephrectomy: a case report

A forty-five-year-old female patient presented with thyroid nodules eight years after radical nephrectomy for renal cell carcinoma T2N0M0, grade 2, clear cell subtype in the right kidney. Ultrasonography of the neck showed multiple hypoechoic macronodules. There was no lymphadenomegaly. During total thyroidectomy following an initial diagnosis of multinodular goiter, frozen section analysis was made, which showed metastasis from renal cell carcinoma. Immunohistochemical studies demonstrated that the tumor cells were negative for thyroglobulin staining. No recurrences or other metastatic disease were seen during a follow-up period of 12 months. Although clinically the thyroid gland is a rare site for tumor metastasis, this possibility should be kept in mind in patients with a previous history of renal cell carcinoma

Keywords:

Carcinoma/secondary, carcinoma, renal cell/ secondary/pathology, kidney neoplasms/pathology, thyroid neoplasms/secondary/surgery, thyroidectomy,

PDF

___

Harach HR, Williams ED. Pathology of thyroid cancer. In: Wheeler MH, Lazarus JH, editors. Diseases of the thyroid: pathophysiology and management. 4th ed. London: Chapmann & Hall; 1994. p. 341-8.
Chen H, Nicol TL, Udelsman R. Clinically significant, isolated metastatic disease to the thyroid gland. World J Surg 1999;23:177-80.
Ivy HK. Cancer metastatic to the thyroid: a diagnostic problem. Mayo Clin Proc 1984;59:856-9.
Li Volsi VA. Pathology of thyroid disease. In: Falk SE, e d i t o r. Thyroid disease: endocrinology, surg e r y, nuclear medicine, and radiotherapy. 2nd ed. Philadelphia: Lippincott Raven; 1997. p. 127-75.
Kocak S. Ender görülen primer tiroit tümörleri ve tiro- ide metastaz yapan kanserler. In: İflgör A, editör. Tiro- it hastalıkları ve cerrahisi. 1. baskı. İstanbul: Avrupa Tıp Yayıncılık; 2000. s. 439-43.
Welch K, Finkbeiner W, Alpers CE, Blumenfeld W, Davis RL, Smuckler EA, et al. Autopsy findings in the acquired immune deficiency syndrome. JAMA 1984; 252:1152-9.
Lasser A, Rothman JG, Calamia VJ. Renal-cell carcino- ma metastatic to the thyroid. Aspiration cytology and histologic findings. Acta Cytol 1985;29:856-8.
Watts NB. Carcinoma metastatic to the thyroid: preva- lence and diagnosis by fine-needle aspiration cytology. Am J Med Sci 1987;293:13-7.
Michelow PM, Leiman G. Metastases to the thyroid gland: diagnosis by aspiration cytology. Diagn Cytopathol 1995;13:209-13.
McCabe DP, Farrar WB, Petkov TM, Finkelmeier W, O’Dwyer P, James A. Clinical and pathologic correla- tions in disease metastatic to the thyroid gland. Am J Surg 1985;150:519-23.
Ericsson M, Biorklund A, Cederquist E, Ingemansson S, Akerman M. Surgical treatment of metastatic dis- ease in the thyroid gland. J Surg Oncol 1981;17:15-23.
Czech JM, Lichtor TR, Carney JA, van Heerden JA. Neoplasms metastatic to the thyroid gland. Surg Gynecol Obstet 1982;155:503-5.