The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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Case of Synchronous Central Neck Node Metastases from Both Primary Thyroid Cancer and from Endometrial Cancer to the Thyroid

갑상선암과 자궁내막암에서 동시에 전이된 경부림프절에 관한 증례

  • Park, Kyeong Seon (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Park, Hyo Jin (Department of Pathology, Seoul National University Bundang Hospital) ;
  • Hong, A Ram (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Kim, Yeong Gi (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Moon, Jae Hoon (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Park, Young Joo (Department of Internal Medicine, Seoul National University College of Medicine)
  • 박경선 (서울대학교 의과대학 내과학교실) ;
  • 박효진 (분당서울대학교병원 병리과) ;
  • 홍아람 (서울대학교 의과대학 내과학교실) ;
  • 김영기 (서울대학교 의과대학 내과학교실) ;
  • 문재훈 (분당서울대학교병원 내과) ;
  • 박영주 (서울대학교 의과대학 내과학교실)
  • Received : 2013.06.10
  • Accepted : 2013.10.02
  • Published : 2014.03.01
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Abstract

A 54-year-old woman presenting with dizziness was diagnosed with a metastatic brain tumor. Imaging studies to identify the primary cancer revealed endometrial thickening with a left adnexal mass, enlarged bilateral external iliac lymph nodes, and multiple attenuated nodules in both lobes of the thyroid gland with enlarged central neck nodes. After curettage of the uterine endometrium and ultrasonography-guided gun biopsy of the thyroid gland to confirm uterine and thyroid cancers, respectively, total abdominal hysterectomy with bilateral salpingo-oophorectomy and total thyroidectomy with bilateral central neck dissection were performed. Histopathologic examination of the removed tissues demonstrated both endometrial carcinoma metastasis to the thyroid gland and primary thyroid cancer with synchronous central neck node metastasis originating in the endometrium and thyroid. Three of the four right central lymph nodes were positive for metastatic papillary carcinoma; on the other hand, the remaining right central lymph node and one of the two left central lymph nodes were confirmed to be positive for metastatic endometrial carcinoma.

Keywords

References

  1. Irani S. Metastasis to head and neck area: a 16-year retrospective study. Am J Otolaryngol 2011;32:24-27. https://doi.org/10.1016/j.amjoto.2009.09.006
  2. Sakorafas GH, Christodoulou S, Lappas C, Safioleas M. Preoperative detection of cervical lymph node metastases in papillary thyroid cancer: a surgical perspective. Onkologie 2009;32:762-766. https://doi.org/10.1159/000255337
  3. Chung YS, Kim JY, Bae JS, et al. Lateral lymph node metastasis in papillary thyroid carcinoma: results of therapeutic lymph node dissection. Thyroid 2009;19:241-246. https://doi.org/10.1089/thy.2008.0244
  4. Kojima M, Yokoyama J, Ito S, Ohba S, Fujimaki M, Ikeda K. Impact of middle and lower jugular neck dissection on supraclavicular lymph node metastasis from endometrial carcinoma. World J Surg Oncol 2012;10:143. https://doi.org/10.1186/1477-7819-10-143
  5. Gupta S, Ajise O, Dultz L, et al. Follicular variant of papillary thyroid cancer: encapsulated, nonencapsulated, and diffuse: distinct biologic and clinical entities. Arch Otolaryngol Head Neck Surg 2012;138:227-233. https://doi.org/10.1001/archoto.2011.1466
  6. Bilici A, Karci E, Altun E, et al. An unusual case of recurrent endometrial cancer presented with isolated cervical lymph node metastasis. Arch Gynecol Obstet 2009;280:153-156. https://doi.org/10.1007/s00404-008-0868-0
  7. Lin JD, Weng HF, Ho YS. Clinical and pathological characteristics of secondary thyroid cancer. Thyroid 1998;8:149-153. https://doi.org/10.1089/thy.1998.8.149
  8. Mete O, Ozbey N, Erbil Y, et al. Thyroid metastasis of endometrial carcinosarcoma associated with Graves' disease. Gynecol Endocrinol 2007;23:562-566. https://doi.org/10.1080/09513590701560733
  9. Chan BK, Desser TS, McDougall IR, Weigel RJ, Jeffrey RB Jr. Common and uncommon sonographic features of papillary thyroid carcinoma. J Ultrasound Med 2003;22:1083-1090. https://doi.org/10.7863/jum.2003.22.10.1083
  10. Tangjitgamol S, Anderson BO, See HT, et al. Management of endometrial cancer in Asia: consensus statement from the Asian Oncology Summit 2009. Lancet Oncol 2009;10:1119-1127. https://doi.org/10.1016/S1470-2045(09)70290-6