Endocrine Abstracts

Despite that the thyroid gland is one of the most vascular organs of the body but thyroid gland is an uncommon site for metastasis [1]. It represents less than 4% of thyroid malignancy in clinical and surgical studies [2, 3]. 58-year-old male, a prior smoker, was diagnosed with nonsmall cell lung cancer T4N3M1 St IV, histopathological findings - infiltrative adenocarcinoma, G1. About eight months he was treated with chemotherapy. At the beginning of the disease, the patient was examined by the endocrinologist and diagnosed a nodule thyroid. A fine needle aspiration (FNA) revealed a cystic degeneration. It was intended to repeat the FNA after three – 6 months. After 2 months, a patient presented to Endocrinology department of Hospital of Lithuanian University of Health Sciences Kauno klinikos because of increasing volume of the neck, shortness of breath, changes in voice and swallowing disorder. Thyroid ultrasound examination showed an enlarged thyroid gland, its structure was hypoechogenous and non-homogenous. Because of rapid tumor growth, we differentiated between lymphoma, anaplastic and hypopharyngeal cancer, lastly metastatic lesion. Metastasis from primary lung cancer was confirmed by thyroid fine-needle aspiration, cervical lymph nodes and laryngeal biopsies. After 1 week complications progressed. Thyroid was dramatically enlarged, acute respiratory failure evolved and the patient was unsuccessfully treated at Intensive Care Unit. In conclusion, a diagnosis of metastatic disease should be considered when new thyroid lesion is identified in any patient with a known history of malignancy until such a diagnosis can be ruled out. Because detection of metastasis to the thyroid gland often indicates a poor prognosis, aggressive treatment in time may be sufficient.