Open Access Highly Accessed Case report

Neuroendocrine tumors presenting with thyroid gland metastasis: a case series

Emre Sivrikoz1, Nese Colak Ozbey2, Bulent Kaya1*, Yesim Erbil1, Serkan Kaya3, Dilek Yilmazbayhan4, Pinar Firat4 and Yersu Kapran4

Author Affiliations

1 Department of General Surgery, Istanbul University, Istanbul Medical School, Capa-Istanbul 34093, Turkey

2 Department of Internal Medicine, Istanbul University, Istanbul Medical School, Capa-Istanbul 34093, Turkey

3 Department of Thoracic Surgery, Istanbul University, Istanbul Medical School, Capa-Istanbul 34093, Turkey

4 Department of Pathology, Istanbul University, Istanbul Medical School, Capa-Istanbul 34093, Turkey

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Journal of Medical Case Reports 2012, 6:73  doi:10.1186/1752-1947-6-73

Published: 27 February 2012

Abstract

Introduction

Autopsy series have shown that metastasis to the thyroid gland has occurred in up to 24% of patients who have died of cancer. Neuroendocrine tumors may metastasize to thyroid gland.

Case presentations

Case 1 was a 17-year-old Turkish woman who was referred from our Endocrinology Department for a thyroidectomy for treatment of neuroendocrine tumor metastasis. She was treated with a bilateral total thyroidectomy. Histopathological examination results were consistent with a neuroendocrine tumor; neoplastic cells showed strong immunoreactivity to chromogranin A and synaptophysin, but the immunohistochemical profile was inconsistent with medullary thyroid carcinoma in that the tumor was negative for calcitonin, carcinoembryonic antigen, and thyroid transcription factor-1.

Case 2 was a 54-year-old Turkish woman who presented with a 3-cm nodule on her right thyroid lobe. She had undergone surgery for a right lung mass four years previously. After a right pneumonectomy, thymectomy and lymph node dissection, a typical carcinoid tumor was diagnosed. Under ultrasonographic guidance, fine needle aspiration biopsy of her right thyroid pole nodule was performed and the biopsy was compatible with a neuroendocrine tumor metastasis. She was treated with a bilateral total thyroidectomy. Histopathological examination indicated three nodular lesions, 5 cm and 0.4 cm in diameter in her right lobe and 0.1 cm in diameter in her left lobe. The tumors were consistent with a neuroendocrine phenotype, showing strong immunoreactivity to chromogranin A and synaptophysin.

Conclusion

Thyroid nodules detected during follow-up of neuroendocrine tumor patients should be thoroughly investigated. A fine needle aspiration biopsy of the thyroid confirms the diagnosis in most cases and leads to appropriate management of those patients and may prevent unnecessary treatment approaches.