Abstract
BackgroundHurthle cell carcinoma of the thyroid is a rare form of thyroid cancer. It may present as a low grade tumour or can present as a more aggressive metastatic carcinoma. Hurthle cell carcinoma has the highest incidence of metastasis among all differentiated thyroid cancers. Most commonly haematogenous spread to lungs, bones and brain, however spread to regional lymph nodes is not uncommon. The breast is a rare site for metastasis from extramammary sources. We present the first case of breast metastasis from Hurthle cell carcinoma of the thyroid.Case presentationWe report a 77 year old lady who had total thyroidectomy and bilateral neck dissection followed by radiotherapy for a high grade metastatic Hurthle cell carcinoma of the thyroid. Ten months later she presented to the breast clinic with left breast lump and a lump at the left axilla. Fine needle aspiration cytology of the lumps and histology after wide local excision of the breast lump confirmed metastatic Hurthle cell carcinoma.ConclusionThe presence of breast lumps in patients with history of extramammary cancer should raise the possibility of metastasis.
Highlights
Hurthle cell carcinoma of the thyroid is a rare form of thyroid cancer
The presence of breast lumps in patients with history of extramammary cancer should raise the possibility of metastasis
There are a number of documented cases with extramammary cancer sources of metastasis including gastric cancer, colon cancer, melanoma, cancer of the cervix, endometrial carcinoma and other rare cancers [1,2,3]
Summary
The breast is a rare site of metastasis from extramammary sources. there are a number of documented cases with extramammary cancer sources of metastasis including gastric cancer, colon cancer, melanoma, cancer of the cervix, endometrial carcinoma and other rare cancers [1,2,3]. Breast metastasis has never been documented following Hurthle cell carcinoma of the thyroid. Hurthle cell carcinoma is a form of follicular cell carci- We present the first case of breast metastasis from Hurthle noma of the thyroid. It is rather unusual and a rare type of cell carcinoma of the thyroid. The patient underwent wide local excision of the left breast nodule and excision of the left posterior axillary fold lump. Histology of both lesions showed large pleomorphic cells with abundant eosinophilic cytoplasm which confirmed metastases from the previously diagnosed Hurthle cell carcinoma of the thyroid (Figure 2). LnFeoigfdtuubrlereeaa1tst hmeaumpmpeorgrinanmer(Lq-umaldor)avnitew(arsrhooww)s dense lobulated Left breast mammogram (L-mlo) view shows dense lobulated nodule at the upper inner quadrant (arrow)
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