title: Solitary intrathyroidal metastasis of renal clear cell carcinoma in a toxic substernal multinodular goiter.
abstract: BACKGROUND
  Thyroid gland is a rare site of clinically detectable tumor metastasis.
  
  
  METHODS
  A 71-year-old woman was referred to our department for an evaluation of toxic multinodular substernal goiter. She had a history of renal clear cell carcinoma of the left kidney, which had been resected 2 years previously. US confirmed the multinodular goiter. Total thyroidectomy with neuromonitoring was performed on March 2008. A histological examination revealed a solitary metastasis of a clear cell renal cancer in a diffuse multinodular goiter. No distant metastases are detected.
  
  
  CONCLUSIONS
  Although uncommon, it is important for the endocrine surgeon and endocrine oncologist to be able to recognize and differentiate intrathyroid metastases from more primary common thyroid neoplasms. The diagnosis can be suspected if the patient has a thyroid tumor and a past history of extrathyroid cancer. These tumors, on the whole, tend to behave more aggressively and, in most cases, the use of multimodality therapy is recommended.
authors.affiliation: Department of Surgical Sciences, University of Insubria, Varese, Italy. gianlorenzo.dionigi@uninsubria.it.
authors.forename: Gianlorenzo
authors.initials: G
authors.lastname: Dionigi
authors.forename: Silvia
authors.initials: S
authors.lastname: Uccella
authors.forename: Myriam
authors.initials: M
authors.lastname: Gandolfo
authors.forename: Adriana
authors.initials: A
authors.lastname: Lai
authors.forename: Valentina
authors.initials: V
authors.lastname: Bertocchi
authors.forename: Francesca
authors.initials: F
authors.lastname: Rovera
authors.forename: Maria Laura
authors.initials: ML
authors.lastname: Tanda