It is no longer the time to disregard thyroid metastases from breast cancer: A case report and review of the literature

Matilde Pensabene, Brigida Stanzione, Ivana Cerillo, Giuseppe Ciancia, Immacolata Cozzolino, Raffaella Ruocco, Caterina Condello, Giuseppe Di Lorenzo, Mario Giuliano, Valeria Forestieri, Grazia Arpino, Sabino De Placido, Rossella Lauria

Research output: Contribution to journalArticle

Abstract

Background: Metastases to the thyroid gland are more frequent than previously thought, although most of them are occult or not clinically relevant. Overall, only 42 cases of metastases to thyroid from breast cancer have been reported thus far. Here we report the case of a patient with breast cancer metastatic to the thyroid. We also review the 42 previously reported cases (published between 1962 and 2012). This is the first review about metastases to thyroid gland from breast cancer. Case presentation: A 64-year-old woman of Caucasian origin was diagnosed with a lobular invasive carcinoma of the breast (luminal A, stage II). She received adjuvant chemotherapy, followed by endocrine therapy. During follow-up, fine-needle cytology of a thyroid nodule revealed malignant cells that were estrogen-positive, which suggested a diagnosis of metastases to the thyroid. Imaging did not reveal any other metastatic site and showed only enlargement of the left thyroid lobe and an inhomogeneous pattern of colloid and cystic degeneration and calcifications. The patient underwent left hemithyroidectomy. Histology of thyroid tissue showed a colloid goitre containing dispersed small atypical neoplastic cells with eccentric nuclei. Immunohistochemistry showed cytokeratin-19 and oestrogen receptor, but not tireoglobulin, e-cadherin or cytokeratin-7, thereby confirming metastases from a lobular breast carcinoma. Hormonal treatment is ongoing. Conclusion: This case report and first review of the literature on metastases to thyroid from breast cancer highlight the importance of a correct early diagnostic work-up in such cases. Indeed, a primary lesion should be distinguished from metastases given the different treatment protocol related to primary cancer and the clinical impact on prognosis.

Original languageEnglish
Article number146
JournalBMC Cancer
Volume18
Issue number1
DOIs
Publication statusPublished - Feb 6 2018

Fingerprint

Thyroid Gland
Breast Neoplasms
Neoplasm Metastasis
Lobular Carcinoma
Colloids
Thyroid Neoplasms
Keratin-7
Keratin-19
Thyroid Nodule
Goiter
Cadherins
Adjuvant Chemotherapy
Clinical Protocols
Estrogen Receptors
Needles
Cell Biology
Histology
Estrogens
Breast
Immunohistochemistry

Keywords

  • Breast cancer
  • Goitre
  • Lobular breast cancer
  • Metastases to thyroid

ASJC Scopus subject areas

  • Oncology
  • Genetics
  • Cancer Research

Cite this

It is no longer the time to disregard thyroid metastases from breast cancer : A case report and review of the literature. / Pensabene, Matilde; Stanzione, Brigida; Cerillo, Ivana; Ciancia, Giuseppe; Cozzolino, Immacolata; Ruocco, Raffaella; Condello, Caterina; Di Lorenzo, Giuseppe; Giuliano, Mario; Forestieri, Valeria; Arpino, Grazia; De Placido, Sabino; Lauria, Rossella.

In: BMC Cancer, Vol. 18, No. 1, 146, 06.02.2018.

Research output: Contribution to journalArticle

Pensabene, M, Stanzione, B, Cerillo, I, Ciancia, G, Cozzolino, I, Ruocco, R, Condello, C, Di Lorenzo, G, Giuliano, M, Forestieri, V, Arpino, G, De Placido, S & Lauria, R 2018, 'It is no longer the time to disregard thyroid metastases from breast cancer: A case report and review of the literature', BMC Cancer, vol. 18, no. 1, 146. https://doi.org/10.1186/s12885-018-4054-x
Pensabene, Matilde ; Stanzione, Brigida ; Cerillo, Ivana ; Ciancia, Giuseppe ; Cozzolino, Immacolata ; Ruocco, Raffaella ; Condello, Caterina ; Di Lorenzo, Giuseppe ; Giuliano, Mario ; Forestieri, Valeria ; Arpino, Grazia ; De Placido, Sabino ; Lauria, Rossella. / It is no longer the time to disregard thyroid metastases from breast cancer : A case report and review of the literature. In: BMC Cancer. 2018 ; Vol. 18, No. 1.
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AU - Di Lorenzo, Giuseppe

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AB - Background: Metastases to the thyroid gland are more frequent than previously thought, although most of them are occult or not clinically relevant. Overall, only 42 cases of metastases to thyroid from breast cancer have been reported thus far. Here we report the case of a patient with breast cancer metastatic to the thyroid. We also review the 42 previously reported cases (published between 1962 and 2012). This is the first review about metastases to thyroid gland from breast cancer. Case presentation: A 64-year-old woman of Caucasian origin was diagnosed with a lobular invasive carcinoma of the breast (luminal A, stage II). She received adjuvant chemotherapy, followed by endocrine therapy. During follow-up, fine-needle cytology of a thyroid nodule revealed malignant cells that were estrogen-positive, which suggested a diagnosis of metastases to the thyroid. Imaging did not reveal any other metastatic site and showed only enlargement of the left thyroid lobe and an inhomogeneous pattern of colloid and cystic degeneration and calcifications. The patient underwent left hemithyroidectomy. Histology of thyroid tissue showed a colloid goitre containing dispersed small atypical neoplastic cells with eccentric nuclei. Immunohistochemistry showed cytokeratin-19 and oestrogen receptor, but not tireoglobulin, e-cadherin or cytokeratin-7, thereby confirming metastases from a lobular breast carcinoma. Hormonal treatment is ongoing. Conclusion: This case report and first review of the literature on metastases to thyroid from breast cancer highlight the importance of a correct early diagnostic work-up in such cases. Indeed, a primary lesion should be distinguished from metastases given the different treatment protocol related to primary cancer and the clinical impact on prognosis.

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