Zhang YY, Xue S, Wang ZM, Jin MS, Chen ZP, Chen G, Zhang Q. Thyroid metastasis from breast cancer presenting with enlarged lateral cervical lymph nodes: A case report. World J Clin Cases 2020; 8(4): 838-847 [PMID: 32149069 DOI: 10.12998/wjcc.v8.i4.838]
Corresponding Author of This Article
Qiang Zhang, MD, PhD, Associate Professor, Department of Thyroid Surgery, The First Hospital of Jilin University, No. 71, Xinmin Street, Changchun 130021, Jilin Province, China. 471497933@qq.com
Research Domain of This Article
Medicine, Research & Experimental
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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/
Yan-Yan Zhang, Shuai Xue, Zheng-Min Wang, Guang Chen, Qiang Zhang, Department of Thyroid Surgery, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Mei-Shan Jin, Department of Pathology, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Zhong-Ping Chen, Department of Radiology, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Author contributions: Zhang YY and Xue S wrote the manuscript; Xue S, Wang ZM, and Zhang Q reviewed the literature and contributed to manuscript drafting; Jin MS and Chen ZP provided the pathological and radiological information and contributed to diagnosis; Xue S, Chen G, and Zhang Q were responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Informed consent statement: Written informed 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 conflict 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: Qiang Zhang, MD, PhD, Associate Professor, Department of Thyroid Surgery, The First Hospital of Jilin University, No. 71, Xinmin Street, Changchun 130021, Jilin Province, China. 471497933@qq.com
Received: December 14, 2019 Peer-review started: December 14, 2019 First decision: December 30, 2019 Revised: January 1, 2020 Accepted: January 11, 2020 Article in press: January 11, 2020 Published online: February 26, 2020 Processing time: 74 Days and 14.3 Hours
Abstract
BACKGROUND
Secondary malignancy of the thyroid occurs infrequently and mainly originates from malignant tumors of the kidney, gastrointestinal tract, lungs, breast, and skin. The correct diagnosis is important but difficult. Importantly, there are major differences in the treatment of primary and metastatic thyroid cancer, which has a significant impact on prognosis and survival. Therefore, how to diagnose thyroid metastasis (TM) correctly before surgery is a major concern for surgeons.
CASE SUMMARY
We report a 38-year-old woman who presented with palpable cervical lymph nodes after breast cancer (BC) surgery 2 years ago. Ultrasonography and computed tomography revealed thyroid nodules with irregular margins and enlarged cervical lymph nodes. Biopsy was performed for the right largest cervical lymph node, and immunohistochemical analysis revealed negativity for thyroglobulin, estrogen receptor, and progestin receptor and positive for human epidermal growth factor receptor 2. The diagnosis was TM from BC with cervical lymph node metastasis. Total thyroidectomy with bilateral central and lateral neck lymph node dissection was performed. After a 5-mo follow-up, no recurrence or novel distant metastasis was identified.
CONCLUSION
TM from BC is a rare secondary malignancy. Broad differential diagnosis by biopsy and immunohistochemical analysis needs to be considered.
Core tip: Thyroid metastasis from breast cancer is a rare secondary malignancy. The correct diagnosis before surgery is important but difficult. Importantly, there are major differences in the treatment of primary and metastatic thyroid cancer, which has a significant impact on prognosis and survival. Because of its low incidence, thyroid metastasis from breast cancer is easily overlooked and misdiagnosed. Broad differential diagnosis by biopsy and immunohistochemical analysis needs to be considered.
