06 August 2018 : Case report
Thyroid Gland Hemorrhage in a Patient with Past Medical History of Renal Clear Cell Carcinoma: Report of a Very Rare Case
Management of emergency care, Rare diseaseZiad Abbassi1ABCDEFG*, Francesco Strano1ABCE, Evangelos Koliakos1CDE, Théodoros Thomopoulos1ACDEF, Michel Christodoulou1CD
Am J Case Rep 2018; 19:920-923
BACKGROUND: The incidence of metastasis to the thyroid gland is extremely rare, with hemorrhage being a particularly uncommon manifestation of metastatic thyroid disease.
CASE REPORT: A 68-year-old man who underwent a right nephrectomy for RCC 8 years ago was referred to the Emergency Department (ED) complaining of upper-chest pain radiating to the left shoulder, tachycardia, and increased dysphonia. An enhanced computed tomography (CT) scan suggested a thyroid mass originating from both thyroid lobes, with right deviation of the trachea due to active bleeding. The patient underwent an emergency total thyroidectomy. The postoperative course was uneventful. The histopathological analysis of the surgical specimen revealed metastasis of an RCC.
CONCLUSIONS: Active bleeding of the thyroid gland is a formal indication for emergency surgical management. In patients with a history of cancer, especially in cases of RCC, metastatic disease should be suspected, although in most cases the final diagnosis can only be made after surgery.
Keywords: Carcinoma, Renal Cell, Goiter, Neoplasm Metastasis, Thyroidectomy
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