A case of occult thyroid cancer detected as a solitary nodular lung metastasis
Masayuki Itoh Shuji Oh-ishi Seitaro Senba Kenji Nemoto Hidekazu Hatao Naohiro Shimizudani Hideki Adachi Kouji Kishi Hiroyuki Nakamura Takeshi Matsuoka
Fifth Department of Internal Medicine, Tokyo Medical University
An 82-year-old woman was admitted to our hospital with cough and back pain. A chest radiograph showed a solitary nodular lesion in the right lower lung field. It was diagnosed by a transbronchial biopsy as lung metastasis of a papillary adenocarcinoma of the thyroid. However, her cervical CT and ultrasonography showed only a cyst in a right lobe of the thyroid, and its biopsy did not show evidence of malignancy. In addition, multiple bone metastasis and pituitary metastasis were revealed. We therefore diagnosed this case as systemic metastasis of papillary adenocarcinoma of the thyroid. She was given best supportive care and she died seven months later. Autopsy revealed two tiny lesions (3 mm and 6 mm) in the thyroid right lobe to be papillary adenocarcinoma. We report this case because occult thyroid cancer caused systemic metastasis and the chest X-ray showed lung metastasis from the thyroid cancer as a solitary nodular lesion.
Solitary lung tumor Lung metastasis Minimal thyroid carcinoma Occult papillary thyroid carcinoma
Received 平成20年1月29日
JJRS, 46(7): 578-582, 2008