Endocrine Abstracts

Introduction: Metastasis to the thyroid gland is a rare clinical presentation. The most common sites of primary tumors that metastasize to the thyroid gland are kidney, lung, gastrointestinal system and breast. Primary gynaecological tumors are account for only 3% of secondary thyroid malignancies. Here, we present a case of thyroid metastasis from squamous cell carcinoma (SCC) of the cervix.

Case: A 54-year-old female was consulted to our clinic with the pathology result of subtotal thyroidectomy. Five years ago, she had been diagnosed with cervical SCC treated with total abdominal hysterectomy and bilateral salpingo-oophorectomy and radiotherapy. The patient had no other known comorbidities. She had a history of lung metastasis. Two months ago, in addition to lung, pathological increased activity uptake (SUVmax 5.7) in the right thyroid lobe was reported in PET-CT. A 7.6 mm hypoechoic nodule was detected in the right thyroid lobe on ultrasound, and the result of fine needle aspiration biopsy was reported to be compatible with SCC. She was operated for lung metastasis last month, SCC was found in two regions, and adenocarcinoma in one region, respectively. Afterwards, right subtotal thyroidectomy was performed for suspected thyroid metastasis. The pathology result was reported as metastatic SCC. Tumoral tissue was 18x17x10 mm and tumor cell groups were scattered among the thyroid follicles. When the patient was consulted, thyroid function tests were normal, calcitonin was negative, thyroglobulin level was 22.4 ng/ml and anti-thyroglobulin 1.5 IU/ml. Thyroglobulin and thyroid transcription factor-1 (TTF-1) staining were requested from the pathology of the patient and negative staining was obtained. The patient was accepted as thyroid metastasis of cervical cancer. In addition to chemotherapy, the patient received radiotherapy to the neck and thorax. Six months later, a 23x20 mm soft tissue lesion was detected in the right thyroid lobe on ultrasound. Three months after that, a 45 mm mass (SUVmax 8.9) extending from the right thyroid lobe to the vertebral corpus was detected on PET-CT. Tracheostomy and gastrostomy were performed. The patient died shortly after.

Conclusion: Thyroid metastasis from cervical cancer is very rare and only a few cases have been reported. Patient who present with a thyroid nodule and has a history of a previous malignancy should be evaluated for metastatic disease.