義大醫院 外科部 泌尿科
A Rare Case of Renal Cell Carcinoma Metastasis to Thyroid after 13 years
Mu-Chiao Tung, Victor C. Lin
Divisions of Urology, Department of Surgery, E-Da Hospital, Kaohsiung, Taiwan
Summary: We are reporting a case of thyroid metastasis of renal cell carcinoma after almost 13 years since renal cell carcinoma diagnosis. A 73-year-old male was diagnosed of left kidney renal cell carcinoma who underwent laparoscopic radical nephroureterectomy in August of 2006. Histopathological examination further specified the tumor to be clear cell predominant and organ confined.
After almost 13 years, the patient came to our endocrine out-patient department in July of 2019 because of left neck swelling noted for months. Thyroid ultrasound revealed a mixed echoic mass (6.0 cm) with intranodal vessels over the left thyroid lobe. Metastatic renal cell carcinoma was diagnosed by frozen section and bilateral thyroidectomy was performed. Final diagnosis of bilateral metastatic clear cell renal cell carcinoma was confirmed. Positron Emission Tomography was arranged after the operation which revealed not only multiple hypermetabolic process in bilateral thyroid bed and infrahyoid muscle, but also over back and flank muscles. Further flank nodules surgical resection was done which proven to be metastatic clear cell renal cell carcinoma.
Currently this patient is followed-up at our urology department receiving target therapy of Sunitinib. Severe skin rash developed under Sunitinib 50 mg QD, so we tapered the dose to 37.5 mg QD. Further adverse effect and treatment efficacy will be evaluated in the future.