Published online Dec 6, 2018. doi: 10.12998/wjcc.v6.i15.1018
Peer-review started: September 18, 2018
First decision: October 8, 2018
Revised: November 1, 2018
Accepted: November 7, 2018
Article in press: November 7, 2018
Published online: December 6, 2018
The optimal therapeutic strategy in treating thyroid metastasis from renal cell carcinoma (RCC) has not been clearly established. Here we describe a case of didactic surgical experience of the disease which caused massive intraoperative bleeding.
A 59-year-old male patient presented with a thyroid left lobe soft mass detected by chest computed tomography scans prior to the surgical treatment of RCC of the left kidney. The thyroid mass was initially considered to be benign, then he underwent left radical nephrectomy. One year after the nephrectomy, stereotactic radiosurgery was performed for brain metastasis. During follow-up, the thyroid nodule gradually grew, and the patient manifested swallowing discomfort. Under a clinical diagnosis of thyroid follicular neoplasm, left hemithyroidectomy was performed. Although hemithyroidectomy is usually a safe and straightforward procedure, massive bleeding from markedly developed tumor vessels made the operation very difficult. The thyroid tumor was finally diagnosed as metastasis from clear cell RCC.
For proper timing of the surgery, a clinician should take into consideration the possibility of thyroid metastasis of RCC when a thyroid lesion is found in patients with RCC or in patients with a previous history of RCC. We recommend that thyroid metastasis of RCC should be resected as early as possible even if a patient has other metastatic sites.
Core tip: A didactic surgical experience of thyroid metastasis from renal cell carcinoma (RCC) which caused massive intraoperative bleeding is presented. Based on this experience, we recommend that thyroid metastasis of RCC should be resected as early as possible even if a patient has other metastatic sites, unless the patient has appropriate reasons to avoid surgery.