Metastatic carcinoma to the thyroid gland from renal cell carcinoma: role of ultrasonography in preoperative diagnosis

Kobayashi, Kaoru; Hirokawa, Mitsuyoshi; Yabuta, Tomonori; Fukushima, Mitsuhiro; Masuoka, Hiroo; Higashiyama, Takuya; Kihara, Minoru; Ito, Yasuhiro; Miya, Akihiro; Amino, Nobuyuki; Miyauchi, Akira

doi:10.1186/s13044-015-0016-4

Thyroid Research

Table 1 Patients with metastatic carcinoma to the thyroid from renal cell carcinoma and ultrasonographic features

From: Metastatic carcinoma to the thyroid gland from renal cell carcinoma: role of ultrasonography in preoperative diagnosis

Patient		History, Side of RCC	Serum Tg, TgAb	Ultrasonographic features of metastatic carcinoma				FNAC	Pre-op. DX	Surgery
No	Age, Sex	History, Side of RCC	Serum Tg, TgAb	Location, Size (mm)	Shape, Pattern, Calc.	Intra-tumoral vascularity	Tumor thrombus	FNAC	Pre-op. DX	Surgery
1	70F	8 yr, Right	81.3 (-)	Rt, 36x19x36	irregular solid, (-)	++	(-)	malignant, meta/RCC	meta/RCC	LO
2	77M	9 yr, Right	9.3 (-)	Rt, 56x35x48	irregular solid, (-)	++	(-)	indeterminate	meta/RCC	LO
3	72M	30 yr, Right	27.4 (-)	Lt, 31x19x24	irregular solid, (-)	++	(-)	benign, AN	meta/RCC	LO
4	58F	10 yr, Right	68.2 (-)	Rt, 39x23x36	irregular solid, (-)	++	(+)	indeteminate	meta/RCC	LO+RTV+RIJV
4	58F	10 yr, Right	68.2 (-)	Rt, 39x23x36	irregular solid, (-)	++	TV-IJV	indeteminate	meta/RCC	LO+RTV+RIJV
5	67F	18 yr, Right	128.5 (+)	Rt, 81x41x70	irregular solid, (-)	++	(+)	malignant, meta/RCC	meta/RCC	TT+RTV+RIJV
5	67F	18 yr, Right	128.5 (+)	Lt, 27x16x18	irregular solid, (-)	++	TV-IJV	malignant, meta/RCC	meta/RCC	TT+RTV+RIJV
6	63F	2 yr, Right	894.6 (-)	Rt, 48x29x30 +LNS	irregular solid, (-)	++	(-)	malignant, meta/RCC	meta/RCC	LO+MND
7*	57M	15 yr, Left	26.1 (-)	Rt, 48x40x43	irregular solid, (-)	+	(+)	malignant, meta/RCC	meta/RCC	LO+RTV
7*	57M	15 yr, Left	26.1 (-)	Rt, 48x40x43	irregular solid, (-)	+	TV	malignant, meta/RCC	meta/RCC	LO+RTV
8	79F	15 yr, Right	24.5 (-)	Rt, 45x33x34	irregular solid, (-)	++	(-)	benign, AN	AN	LO
9	65F	(-)** Right	70.7 (-)	Rt, 23x20x21	regular solid, (-)	+	(-)	fol. tumor, FT	FT	LO
10	70M	(-)** Right	30.2 (-)	Rt, 25x19x19	irregular solid, (-)	++	(+)	benign, AG	AG or PC?	TT+CND+RTV
10	70M	(-)** Right	30.2 (-)	Lt, 12x5x10	irregular solid, (-)	++	TV	benign, AG	AG or PC?	TT+CND+RTV

A previous history of renal cell carcinoma was recognized in 7 patients (Patients 1-7) before surgery, and in 3 patients (Patients 8-10) it was not. Age: age at thyroid surgery, F: female, M: male, Rt: right, Lt: left, History: previous history of nephrectomy for renal cell carcinoma, RCC: renal cell carcinoma, Tg: thyroglobulin (normal range: < 40 ng/ml), TgAb: anti-thyroglobulin autoantibody. Shape of the tumor was classified into regular or irregular. Pattern of the tumor was classified into solid, mixed, or cystic. Calc.: intra-tumoral calcification; (+) or (-). Intra-tumoral vascularity was classified into -, +, or ++ according to the intensity of blood signals by Doppler ultrasonography. FNAC: fine-needle aspiration cytology, Pre-op. DX: preoperative diagnosis, meta/RCC: metastatic carcinoma to the thyroid from renal cell carcinoma, LO: lobectomy of the thyroid, TT: total thyroidectomy, MND: modified neck dissection, CND: central node dissection, TV: thyroid vein, IJV: internal jugular vein RIJV: partial resection of internal jugular vein, RTV: resection of thyroid vein, LNS: lymph node swelling in the neck, FT: follicular tumor, AN: adenomatous nodule, AG: adenomatous goiter, PC; papillary carcinoma. Patient 7*: Metastatic renal cell carcinoma in benign adenomatous nodule. The benign part of the tumor could not be detected on ultrasonography because of small size. (-)**: Existence of renal cell carcinoma was recognized after the thyroid surgery and the histopathological diagnosis of thyroid tumor.

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