Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 6, 2020; 8(19): 4588-4594
Published online Oct 6, 2020. doi: 10.12998/wjcc.v8.i19.4588
Metastasis of esophageal squamous cell carcinoma to the thyroid gland with widespread nodal involvement: A case report
Xing Zhang, Xin Gu, Jia-Gen Li, Xian-Jie Hu
Xing Zhang, Department of Thyroid and Breast Surgery, The Affiliated People's Hospital of Ningbo University, Ningbo 315040, Zhejiang Province, China
Xin Gu, Department of Pathology, The Affiliated People’s Hospital of Ningbo University, Ningbo 315040, Zhejiang Province, China
Jia-Gen Li, Xian-Jie Hu, Department of Thyroid and Breast Surgery, The Affiliated People’s Hospital of Ningbo University, Ningbo 315040, Zhejiang Province, China
Author contributions: Zhang X and Hu XJ admitted the patient and performed the surgery; Gu X was the pathologist who made the diagnosis and analyzed and interpreted the pathological findings; Zhang X reviewed the literature and contributed to manuscript drafting; Zhang X and Li JG revised the manuscript; All authors approved the final version of the manuscript to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Xing Zhang, MD, Chief Doctor, Department of Thyroid and Breast Surgery, The Affiliated People's Hospital of Ningbo University, No. 251 Baizhang East Road, Ningbo 315040, Zhejiang Province, China. zhangx1026@126.com
Received: April 22, 2020
Peer-review started: April 22, 2020
First decision: August 8, 2020
Revised: August 18, 2020
Accepted: September 10, 2020
Article in press: September 10, 2020
Published online: October 6, 2020
Processing time: 158 Days and 18.6 Hours
Abstract
BACKGROUND

Esophageal cancer is one of the most common causes of cancer-related death. Some patients with esophageal cancer have distant metastases at the time of diagnosis, but metastasis to the thyroid gland (MTG) and multifocal thyroid lesions alone are extremely rare.

CASE SUMMARY

In this case report, we present a case of a 69-year-old male with esophageal MTG. The patient visited our hospital for a routine body check-up, which revealed multifocal nodules in his thyroid lobes and enlarged cervical lymph nodes. A fine needle aspiration biopsy showed malignancies in both thyroid lesions and lymph nodes. The patient was initially diagnosed with primary bilateral thyroid cancer that spread to his lymph nodes, and a total thyroidectomy was performed. The histology showed MTG and therefore, a diagnostic work-up was implemented to determine the primary tumor. A fluorine-18-deoxyglucose positron emission tomography scan showed that the lower part of the esophagus and the lymph nodes in the neck, chest, and abdomen were involved. An esophagogastroscopy and corresponding pathology revealed distal esophageal squamous cell carcinoma. The esophageal MTG diagnosis was confirmed with pathological immunohistochemistry.

CONCLUSION

This case report highlights the difficulty in diagnosing esophageal MTG. Patients may have no malignancy history and be asymptomatic. Further diagnostic procedures are necessary after MTG is confirmed by cytology or histology, and the final diagnosis should be made according to the identification of the primary malignancy combined with pathological immunohistochemistry findings.

Keywords: Esophageal squamous cell carcinoma; Metastasis; Thyroid gland; Thyroidectomy; Lymph nodes; Case report

Core Tip: Metastasis to the thyroid gland (MTG) from esophageal cancer is rare, and only a few sporadic cases have been reported thus far. This study reports the findings of esophageal squamous cell carcinoma MTG in a 69-year-old man who presented for a routine checkup. The patient underwent bilateral thyroidectomy. The histology showed MTG. A diagnostic work-up was implemented and revealed metastasis of esophageal squamous cell carcinoma to the thyroid gland with widespread nodal involvement. He was administered four rounds of chemotherapy and is well 1 year after the diagnosis. Our findings will be of importance for diagnosing this rare condition.