A Multimodal and Pathological Analysis of a Renal Cell Carcinoma Metastasis to the Thyroid Gland 11 Years Post Nephrectomy

J Radiol Case Rep. 2019 Apr 30;13(4):1-9. doi: 10.3941/jrcr.v13i4.3497. eCollection 2019 Apr.

Abstract

Thyroid lesions have a comprehensive differential diagnosis which include benign and malignant entities, such as metastases. However, metastases only account for a small percentage of thyroid lesions with renal cell carcinoma as the most common. Metastases to the thyroid pose a diagnostic dilemma as symptoms may not manifest for up to decades after removal of the renal cell carcinoma. Due to the nonspecific appearance on computed tomography and ultrasound, distinguishing metastases from primary thyroid malignancies is of the utmost importance for timely patient management. Our case demonstrates the importance of considering RCC metastases to the thyroid even years after nephrectomy to mitigate potential delays in diagnosis. We present the case of a 66-year-old male with a past medical history of renal cell carcinoma status post nephrectomy 11 years prior who demonstrated incidental thyroid abnormalities on positron emission tomography/computed tomography and ultrasound later confirmed as a metastasis of renal cell carcinoma.

Keywords: Carcinoma; Computed Tomography; Hypervascular Mass; Neoplasm Metastasis; Positron Emission Tomography Computed Tomography; Renal Cell; Thyroid Gland; Ultrasonography.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Carcinoma, Renal Cell / diagnostic imaging*
  • Carcinoma, Renal Cell / pathology
  • Carcinoma, Renal Cell / secondary*
  • Diagnosis, Differential
  • Humans
  • Kidney Neoplasms / pathology*
  • Kidney Neoplasms / surgery*
  • Male
  • Nephrectomy*
  • Positron Emission Tomography Computed Tomography
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / pathology
  • Thyroid Neoplasms / diagnostic imaging*
  • Thyroid Neoplasms / pathology
  • Thyroid Neoplasms / secondary*
  • Time Factors
  • Ultrasonography