Papillary thyroid cancer can usually metastasize to neck lymph nodes. Distant metastases are generally seen as solid organ metastases, in contrast, skin metastasis can rarely be seen. We present a case with papillary thyroid cancer diagnosed with skin metastasis as first clinical sign of distant organ metastasis. A 63-year-old male patient admitted with a skin lesion in the left lateral neck. He had undergone subtotal thyroidectomy 14 years ago without relevant history of malignancy. Follicular variant papillary thyroid cancer was detected in the excisional biopsy performed from the cutaneous lesion. A 12 × 10 × 8 mm hyperechoic nodule in the left lobe was detected in USG and evaluated as Bethesta-III in fine needle aspiration biopsy. Bilateral multiple lung metastases were detected on thorax CT, trucut-biopsied from largest nodule and confirmed as metastasis. Carcinoma was not detected in total thyroidectomy, and post-operative multiple RAI therapies were applied. Patients without history of thyroid cancer rarely present with skin metastases and thyroid cancer should not be overlooked in differential diagnosis. Despite meticulous evaluation of the thyroidectomy specimen, tumor may not be detected in the gland. Skin metastasis in papillary thyroid cancer should be evaluated as distant metastasis and investigations for other metastases should be done, and the treatment should be planned in a multidisciplinary manner.
Papillary thyroid cancer can usually metastase the neck lymph glands. Although distant metastases are often seen as solid organ metastases, very rarely they can make skin metastases. In this study, we aimed at presenting the papillary thyroid cancer phenomenon that applies to skin metastasis as the first discovery of remote organ metastasis. A 63-year-old man with a skin injury on the left side of the neck. 14 years ago, a subtotal thyroidectomy was performed and malignity in his pathology was not detected, the exotic biopside of the newly developing neck in the left side of the follicular variable papillary cancer was detected. In the USG made, the IAB of the 12x10x8 mm hypereconic nodule in the left lob was considered Bethesta 3. In Toraks BT was detected harmful injury with bilateral multiple lung metastasis and the bigger nodule-made trucut biopsy was in harmony with the metastasis. Total thyroidectomy was performed and cancer was not detected in the pathology. The patient received postoperative multiple RAI treatment. Patients with no history of thyroid cancer can very rarely be present with skin metastases and thyroid cancer should not be ignored in the distinctive diagnosis. Despite careful assessment of the thyroidectomy specimum performed after skin metastasis, the thyroid tumor may not be detected. In papillary thyroid cancer, skin metastasis should be considered as a remote metastasis and should be investigated in terms of other remote metastases, treatment should be planned multidisciplinary. (SETB-2021-05-150)
Alan : Sağlık Bilimleri
Dergi Türü : Ulusal
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