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A Rare Malignancy in The Thyroid Gland: Metastasis of Clear Cell Renal Cell Carcinoma

Year 2022, Volume: 1 Issue: 2, 57 - 61, 01.10.2022

Abstract

Aim: Metastasis to the thyroid gland is rarely encountered clinical condition. The frequency is less than 1%. Clear cell renal cell carcinoma (CRCC) with breast, skin and stomach cancer are the tumors which metastasize to the thyroid. Case report: 66 years old patient has been diagnosed CRCC following left nephrectomy in year 2009. He has been total thyroidectomy following detection of mass in his thyroid in 2011. Pathology of the thyroid were RCCC. He has been treated with interferon for 2 years. His PET scan detected pulmonary nodule on the left lung mediobasal segment with standardized uptake value (SUV) 2.05 and 13 mm. Than wedge resection was performed. Pathology is also CRCC metastases. Sunitinib was started for recurrent tumour. Because of grade 3 diarrhea secondary to sunitinib nivolumab was started. He is disease free with nivolumab up to now. Result: Thyroid metastase of CRCC appears as painless rapidly growing neck mass following nephrectomy. Before targeted therapies interferon and interleukine were the biochemical agents used in chemotreatment of this tumor. But tyrosine kinase inhibitors like sunitinib, pazopanib, sorafenib and M-TOR inhibitors like everolimus, temsirolimus are used in the treatment of CRCC. Patients intolerant to these molecules check point inhibitors like nivolumab, ipilimumab and pembrolizumab are used. This case warns us that CRCC should be followed up regularly and that metastasis may be observed in very late period.

References

  • Arasaratnam, M., Gurney, H. (2018). Nivolumab in the treatment of advanced renal cell carcinoma. Future Oncology, 14(17), 1679-1689.
  • Atzpodien, J., Kirchner, H., & Poliwoda, H. (1996). Interleukin-2-haltige ambulante Therapie des metastasierenden Nierenzellkarzinoms [Interleukin 2 based ambulatory therapy of metastatic renal cell carcinoma]. Medizinische Klinik (Munich, Germany: 1983), 91 Suppl 3, 38–43.
  • Budczies, J., von Winterfeld, M., Klauschen, F., Bockmayr, M., Lennerz, J. K., Denkert, C, et. al. (2015). The landscape of metastatic progression patterns across major human cancers. Oncotarget. 6(1), 570-583.
  • Chung, A. Y., Tran, T. B., Brumund, K. T., Weisman, R. A., & Bouvet, M. (2012). Metastases to the thyroid: a review of the literature from the last decade. Thyroid: Official Journal of the American Thyroid Association, 22(3), 258–268. https://doi.org/10.1089/thy.2010.0154
  • Escudier, B., Porta, C., Schmidinger, M., Rioux-Leclercq, N., Bex, A., Khoo, V., et al. (2019). Renal cell carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology: Official Journal of the European Society for Medical Oncology, 30(5), 706-720.
  • HooKim, K., Gaitor, J., Lin, O., & Reid, M. D. (2015). Secondary tumors involving the thyroid gland: A multi-institutional analysis of 28 cases diagnosed on fine-needle aspiration. Diagnostic Cytopathology, 43(11), 904-911.
  • Kaliszewski, K., Szkudlarek, D., Kasperczak, M., & Nowak, Ł. (2019). Clear cell renal carcinoma metastasis mimicking primary thyroid tumor. Polish Archives of Internal Medicine, 129(3), 211-214.
  • Khaddour, K., Marernych, N., Ward, W. L., Liu, J., Pappa, T. (2019). Characteristics of clear cell renal cell carcinoma metastases to the thyroid gland: A systematic review. World Journal of Clinical Cases, 7(21), 3474-3485.
  • Lam, J. S., Leppert, J. T., Figlin, R. A., & Belldegrun, A. S. (2005). Surveillance following radical or partial nephrectomy for renal cell carcinoma. Current Urology Reports, 6(1), 7–18. https://doi.org/10.1007/s11934-005-0062-x

Tiroidde Nadiren İzlenen Bir Malignite: Böbreğin Berrak Renal Hücreli Karsinom Metastazı

Year 2022, Volume: 1 Issue: 2, 57 - 61, 01.10.2022

Abstract

Amaç: Malignitelerde tiroid bezine metastaz nadir olup, tiroid nodülleri içinde sıklığı % 1’den azdır. Diğer kanserlerde olduğu gibi, böbreğin berrak renal hücreli karsinomu (BRHK) da tiroid bezine metastaz yapabilir. BRHK’nın tiroid bezine metastazı, genellikle BRHK tanısı konduktan yıllar sonra meydana gelebilir. Olgu: Altmışaltı yaşında erkek 2009 senesinde BRHK sol nefrektomi yapılmış. Takiplerinde 2011 yılında boyunda kitle saptanması nedeni ile total tiroidektomi yapılmış. Adjuvan tedavi olarak iki sene interferon (IFN) uygulanmış. Remisyona giren hastanın Nisan 2019 senesinde yapılan pozitron emisyon tomografide (PET) sol akciğer medio-bazalde standartlaştırılmış alım değeri (standardized uptake value-SUV) 2.05 olan 13 mm’lik nodül saptanmış ve wedge rezeksiyon ile kitle alınmış. Patolojik incelemede BBHK metastazı saptanmış. Sunitinib tedavisi başlanan hastada grade 3 ishal gelişmesi nedeniyle tedavi değişikliği yapılarak nivolumab tedavisine geçilmiş. Tam yanıt elde edilen hasta halen poliklinik takipleri altındadır. Sonuç: BRHK'nın tiroid bezine metastazı nadir karşılaşılan bir durum olup, sıklıkla nefrektomiden sonra ağrısız, hızlı büyüyen servikal kitle şeklinde karşımıza gelir. Günümüzde BRHK tedavisinde sunitinib, pazopanib, sorafenib gibi tirozin kinaz inhibitörleri, everolimus ve temsirolimus gibi M-TOR inhibitörleri ve ipilimumab, pembrolizumab ve benzeri immun check-point inhibitörleri kullanılmaktadır. Bizim vakamızda olduğu gibi, BBHK tanısı konduktan çok uzun zaman sonra da metastaz görülebileceği için bu hastaların düzenli takip edilmesi gerekmektedir.

References

  • Arasaratnam, M., Gurney, H. (2018). Nivolumab in the treatment of advanced renal cell carcinoma. Future Oncology, 14(17), 1679-1689.
  • Atzpodien, J., Kirchner, H., & Poliwoda, H. (1996). Interleukin-2-haltige ambulante Therapie des metastasierenden Nierenzellkarzinoms [Interleukin 2 based ambulatory therapy of metastatic renal cell carcinoma]. Medizinische Klinik (Munich, Germany: 1983), 91 Suppl 3, 38–43.
  • Budczies, J., von Winterfeld, M., Klauschen, F., Bockmayr, M., Lennerz, J. K., Denkert, C, et. al. (2015). The landscape of metastatic progression patterns across major human cancers. Oncotarget. 6(1), 570-583.
  • Chung, A. Y., Tran, T. B., Brumund, K. T., Weisman, R. A., & Bouvet, M. (2012). Metastases to the thyroid: a review of the literature from the last decade. Thyroid: Official Journal of the American Thyroid Association, 22(3), 258–268. https://doi.org/10.1089/thy.2010.0154
  • Escudier, B., Porta, C., Schmidinger, M., Rioux-Leclercq, N., Bex, A., Khoo, V., et al. (2019). Renal cell carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology: Official Journal of the European Society for Medical Oncology, 30(5), 706-720.
  • HooKim, K., Gaitor, J., Lin, O., & Reid, M. D. (2015). Secondary tumors involving the thyroid gland: A multi-institutional analysis of 28 cases diagnosed on fine-needle aspiration. Diagnostic Cytopathology, 43(11), 904-911.
  • Kaliszewski, K., Szkudlarek, D., Kasperczak, M., & Nowak, Ł. (2019). Clear cell renal carcinoma metastasis mimicking primary thyroid tumor. Polish Archives of Internal Medicine, 129(3), 211-214.
  • Khaddour, K., Marernych, N., Ward, W. L., Liu, J., Pappa, T. (2019). Characteristics of clear cell renal cell carcinoma metastases to the thyroid gland: A systematic review. World Journal of Clinical Cases, 7(21), 3474-3485.
  • Lam, J. S., Leppert, J. T., Figlin, R. A., & Belldegrun, A. S. (2005). Surveillance following radical or partial nephrectomy for renal cell carcinoma. Current Urology Reports, 6(1), 7–18. https://doi.org/10.1007/s11934-005-0062-x
There are 9 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Olgu Sunumu
Authors

Oguz Dikbas 0000-0001-9875-6065

Aslıhan Alpaslan 0000-0002-3629-0906

Neslihan Özyurt 0000-0002-1404-8983

Süleyman Baylan 0000-0003-3605-883X

Gülname Fındık Güvendi 0000-0001-9370-4880

Publication Date October 1, 2022
Published in Issue Year 2022 Volume: 1 Issue: 2

Cite

APA Dikbas, O., Alpaslan, A., Özyurt, N., Baylan, S., et al. (2022). Tiroidde Nadiren İzlenen Bir Malignite: Böbreğin Berrak Renal Hücreli Karsinom Metastazı. Doğu Karadeniz Sağlık Bilimleri Dergisi, 1(2), 57-61.

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