Rare localisation of breast cancer metastasis to thyroid gland

Abstract

Introduction. Metastases to the thyroid gland are very rare. They are usually seen in malignant melanoma, kidney, breast cancer and lung cancer. Case report. We presented a 54- years-old female patient with breast cancer diagnosed in 2002. The adequate surgical procedure was done and the tumor and axillary lymph nodes were removed. The patient also received adjuvant postoperative chemotherapy. After seven years of a disease free period, the first relapse of the disease was detected as thyroid gland tumor with axillary lymphadenopathy. The patient had a good response to systemic treatment so the surgical removal of thyroid gland and enlarged lymph nodes was performed. Histopathological analysis confirmed metastasis with breast cancer origin. Radical mastectomy was also preformed. Second relapse of the disease was detected 10 months later, while the patient was on hormonal therapy. It was manifested as the appearance of bone and skin metastases, pleural effusion and lymphadenopathy. Conclusion. This case report emphasized the importance of detailed examination of any new onset of thyroid swelling in a patient with previous history of malignancy.Uvod. Metastaze u stitnoj zlezdi veoma su retke. Najcesce se vidjaju kod malignog melanoma, karcinoma bubrega, karcinoma dojke i karcinoma pluca. Prikaz bolesnika. Kod bolesnice, stare 54 godine, postavljena je dijagnoza karcinoma dojke 2002. godine. Sprovedeno je adekvatno hirursko lecenje pri cemu su uklonjeni tumor i limfni cvorovi iz istostrane pazusne jame. Bolesnica je primila i adjuvantnu postoperativnu citostatsku terapiju. Nakon sedam godina doslo je do prvog relapsa bolesti koji se manifestovao pojavom cvora u stitnoj zlezdi i uvecanim limfnim cvorovima u pazusnoj jami. Bolesnica je dobro odgovorila na sistemsku hemioterapiju, pa je sprovedeno hirursko uklanjanje stitne zlezde i uvecanih limfnih cvorova. Patohistoloska analiza potvrdila je da se radi o metastazi karcinoma dojke. Takodje, ucinjena je i radikalna mastektomija obolele dojke. Drugi relaps bolesti registrovan je nakon 10 meseci, dok je bolesnica bila na hormonskoj terapiji. Detaljnom procenom bolesti potvrdjeno je prisustvo metastaza u kostima, na kozi, pleuralni izliv i uvecanje limfnih cvorova. Zakljucak. Ovaj prikaz ukazuje na vaznost detaljnog ispitivanja svakog novonastalog uvecanja stitne zlezde kod bolesnika sa prethodnom istorijom malignog oboljenja.