Endocrine Abstracts

Introduction: Breast cancer is the most frequently diagnosed cancer in women. Common sites of metastatic spread are bone, lungs and liver. Metastases to the thyroid gland are exceptional.

Objectives: The aim of the study is to document two rare cases of thyroid metastasis from breast carcinoma and to specify their clinical, radiological and therapeutic particularities.

Methods: Review of 2 clinical cases of thyroid gland metastasis identified in women with no known breast carcinoma.

Case1: 73-year-old patient with a history of chronic renal failure, was referred to our department for an anterior cervical tumefaction evolving for 8 months. The physical examination showed a lower anterior cervical swelling. Cervical ultrasound showed a 3 cm calcified left thyroid nodule. The patient underwent a left lobo-isthmectomy. The final pathology with immunohistochemical studies revealed an intrathyroidal metastasis from an infiltrating ductal carcinoma of the breast. The patient was therefore referred to her gynaecologist and the primary breast origin was confirmed. The evolution was good with a follow-up of 24 months.

Case2: The second case was a 70-year-old woman with no pathologic history, admitted for the management of high dyspnea and progressive dysphonia for 2 months. On examination, she presented a hard lower cervical swelling with a non-palpable lower border, without cervical adenopathy. Laryngoscopy showed a fixity of the left vocal cord. Cervical ultrasound and scan confirmed the thyroid origin of this mass by showing a plunging calcified lower left nodule. Fine needle aspiration, suggested a follicular thyroid carcinoma. The treatment was surgical. The patient underwent a total thyroidectomy with bilateral dissection of sectors VI and a tracheotomy for her dyspnea. The histological examination revealed an intrathyroidal metastasis of a poorly differentiated carcinoma of the breast. The patient was then lost sight of.

Conclusion: Intra thyroid metastases, although rare, should be considered in any patient, especially females. Rarely observed in clinical practice, they often pose a diagnostic and therapeutic challenge.