Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2018; 6(15): 1018-1023
Published online Dec 6, 2018. doi: 10.12998/wjcc.v6.i15.1018
Didactic surgical experience of thyroid metastasis from renal cell carcinoma: A case report
Moriyasu Yamauchi, Keita Kai, Natsuko Shibamiya, Rintaro Shimazu, Mikio Monji, Kumiko Suzuki, Hiroaki Kakinoki, Shohei Tobu, Yuichiro Kuratomi
Moriyasu Yamauchi, Natsuko Shibamiya, Rintaro Shimazu, Mikio Monji, Kumiko Suzuki, Yuichiro Kuratomi, Department of Otolaryngology Head and Neck Surgery, Saga University Faculty of Medicine, Saga 849-8501, Japan
Keita Kai, Department of Pathology, Saga University Hospital, Saga 849-8501, Japan
Hiroaki Kakinoki, Shohei Tobu, Department of Urology, Saga University Faculty of Medicine, Saga 849-8501, Japan
Author contributions: Yamauchi M is the main author of this article; Shibamiya N, Shimazu R, Monji M, Suzuki K, Kakinoki H, Tobu S and Kuratomi Y contributed to the treatment of the patient; Kai K performed the pathological diagnosis, edit the manuscript and contributed to make figures; all authors contributed to the acquisition of data and writing; all authors have read and approved the final manuscript.
Supported by JSPS Grant-in-Aid for Young Scientists (B), No. 16K20254.
Informed consent statement: Written informed consent was obtained.
Conflict-of-interest statement: The authors declare that there are no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Moriyasu Yamauchi, MD, PhD, Assistant Professor, Doctor, Department of Otolaryngology Head and Neck Surgery, Saga University Faculty of Medicine, 5-1-1 Nabeshima, Saga 849-8501, Japan. yamamori@cc.saga-u.ac.jp
Telephone: +81-952-342379 Fax: +81-952-342020
Received: September 16, 2018
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
Abstract
BACKGROUND

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.

CASE SUMMARY

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.

CONCLUSION

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.

Keywords: Renal cell carcinoma, Thyroid metastasis, Hemorrhage, Thyroidectomy, Case report

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.