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Ultrasonographic Features and the Diagnostic Role of Core Needle Biopsy at Metastatic Breast Cancer in the Thyroid gland: A Case Report

갑상선에 생긴 전이성 유방암의 초음파 소견 및 중심부 바늘 생검의 진단적 가치: 증례 보고

  • Dong Hyun Lee (Department of Radiology, Eulji Medical Center, University of Eulji College of Medicine) ;
  • Ra Gyoung Yoon (Department of Radiology, Eulji Medical Center, University of Eulji College of Medicine) ;
  • Jin Kyung An (Department of Radiology, Eulji Medical Center, University of Eulji College of Medicine) ;
  • Jeong Joo Woo (epartment of Radiology, Eulji Medical Center, University of Eulji College of Medicine)
  • 이동현 (을지대학교 의과대학 을지병원 영상의학과) ;
  • 윤라경 (을지대학교 의과대학 을지병원 영상의학과) ;
  • 안진경 (을지대학교 의과대학 을지병원 영상의학과) ;
  • 우정주 (을지대학교 의과대학 을지병원 영상의학과)
  • Received : 2019.06.04
  • Accepted : 2019.10.31
  • Published : 2020.05.01

Abstract

Metastases to the thyroid gland have rarely been reported in clinical settings, and the thyroid gland is an uncommon site for breast carcinoma metastasis. We report a case of a 64-year-old breast cancer patient diagnosed with metastatic breast carcinoma in the thyroid gland after performing ultrasonography (US)-guided core needle biopsy (CNB) and subsequent total thyroidectomy. On US, the thyroid lesion appeared to be mildly enlarged with multiple internal hypoechoic lines and a few microcalcifications without mass formation. Under US-guidance, CNB was performed by targeting the area with microcalcifications and subsequently diagnosed as metastatic breast carcinoma. Total thyroidectomy revealed that the patient had metastatic invasive ductal carcinoma of the breast with lymphatic spread involving both lobes and the isthmus of the thyroid gland. Although the thyroid gland is an uncommon metastatic site, the unusual features of thyroid metastasis can be observed on US; thus, US-guided CNB effectively aids the diagnosis of thyroid metastasis.

갑상선으로의 전이는 매우 드물며, 유방암의 갑상선으로의 전이 또한 드문 것으로 알려져 있다. 우리는 64세 유방암 환자에서 발생한 갑상선으로의 전이성 암 병변에 대한 초음파 소견과 중심부 바늘 생검의 진단적 역할에 중점을 두어 증례 보고를 하고자 한다. 초음파에서는 뚜렷한 종괴 형성은 보이지 않으면서 갑상선의 크기가 증가하였고, 저에코의 선 형태와 미세석회화가 관찰되었다. 이러한 미세석회화 부분을 조직검사의 표적으로 하여 중심부 바늘 생검을 시행하였고, 생검 결과 전이성 유방암으로 확인되었다. 최종적으로 갑상선 전절제술을 시행하여 림프선을 따라 전이한 침윤성 유관암으로 진단되었다. 저자들은 이러한 초음파 소견을 보일 경우 미세침흡인생검으로는 표적을 정하기 어려울 수 있으나, 중심부 바늘 생검을 이용하면 조직 자체를 얻어 수술 전 정확한 진단에 도움이 될 수 있다는 것을 경험하였기에 보고하고자 한다.

Keywords

References

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