Acute airway failure secondary to thyroid metastasis from renal carcinoma.
BACKGROUND
Secondary involvement of the thyroid gland by malignant metastases is uncommon. Acute respiratory crisis due to infiltration of the upper airways is a recognised complication of anaplastic thyroid carcinoma or thyroid lymphoma. Renal cell carcinoma is a tumour that metastasizes diffusely and in an unpredictable manner.


METHODS
We report a case of a 73-year-old man with a painful neck mass, dyspnoea, stridor and dysphonia that was evaluated in emergency. A right radical nephrectomy for renal cell carcinoma was performed 8 years previously. An emergency endotracheal intubation was followed by total thyroidectomy. Histological examination confirmed the diagnosis of thyroid metastasis from renal cell carcinoma.


CONCLUSIONS
A literature review regarding emergency treatment for acute respiratory compromise resulting from secondary thyroid tumours was undertaken. Only two cases of metastatic colon cancer and one case of metastatic meningioma requiring emergency thyroidectomy for acute respiratory failure are reported in the literature. This appears to be the first case of emergency surgery performed for acute respiratory compromise due to thyroid metastasis from renal cell carcinoma.
Testini
Mario
M
Department of Applications in Surgery of Innovative Technologies; University Medical School of Bari, Italy. mario.testini@tin.it
Lissidini
Germana
G
Gurrado
Angela
A
Lastilla
Gaetano
G
Ianora
Amato Stabile
AS
Fiorella
Raffaele
R
D000208:Acute Disease; D000368:Aged; D000402:Airway Obstruction / Q000175:diagnosis / Q000209:etiology*; D001707:Biopsy, Needle; D002292:Carcinoma, Renal Cell / Q000556:secondary* / Q000601:surgery; D004636:Emergency Service, Hospital; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007680:Kidney Neoplasms / Q000473:pathology* / Q000601:surgery; D008297:Male; D009392:Nephrectomy / Q000379:methods; D018570:Risk Assessment; D013964:Thyroid Neoplasms / Q000150:complications* / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D013965:Thyroidectomy / Q000379:methods; D016896:Treatment Outcome