Intra-thyroid Metastasis Revealing Bronchial Cancer

Abstract

Thyroid metastases are rare. They may exceptionally reveal the primary cancer. Several hypotheses have been proposed to explain the low rate of thyroid metastases. The diagnosis is sometimes difficult to establish because the lesions are most often asymptomatic. Ultrasound and scanner are not specific. Histological examination and immune histochemical analysis is the key to diagnosis. Curative management depends on the histological type and the resect ability of the primary tumor. We report the case of a patient who presented with cervical swelling associated with dysphonia; clinical examination found a thyroid nodule confirmed by cervical ultrasound associated with a forearm mass. The patient underwent a left isthmolobectomy and then a right totalization. Histological examination was in favor of an intra-thyroid metastasis of an adenocarcinoma of pulmonary origin. The extension work-up showed pulmonary nodules and bone metastases. The patient underwent chemotherapy with good progression. Finally, the diagnosis of thyroid metastases must always be evoked in front of a swelling of the thyroid gland especially in the presence of a history of neoplasia.