title: Synchronous thyroid and colon metastases from epidermoid carcinoma of the lung: case report.
abstract: BACKGROUND
  Non-small cell lung cancer (NSCLC) progresses to distant metastases in most cases. The most frequent sites for distant metastases are the bones, central nervous system, adrenal glands and liver. Dissemination to the skin, myocardium, thyroid gland and intestine may occur, but is rare.
  
  
  METHODS
  We describe a case of squamous cell carcinoma in the lungs, with metastases in the colon and thyroid, in a 66-year-old female patient. The lesion was unresectable and chemotherapy was started. The patient evolved with intestinal subocclusion, and colonoscopy showed the presence of a polyp. Biopsy and immunohistochemical analysis on the polyp showed that it was compatible with squamous cell carcinoma of pulmonary origin. At a follow-up consultation, the patient presented a thyroid nodule. A aspiration biopsy and cellblock immunohistochemistry confirmed the squamous cell carcinoma of pulmonary origin. After third-line chemotherapy, the patient progressed with acute obstructive abdomen due to a retroperitoneal mass. She underwent exploratory laparotomy and died due to surgical complications. Metastases to the thyroid and colon are rarely reported in cases of epidermoid carcinoma of the lungs. Gastrointestinal involvement in pulmonary metastases may affect the stomach, small intestine and colon, and cases of bleeding and perforation have already been reported. Although richly vascularized, the thyroid is an infrequent site for metastases. Such sites reflect poor prognoses for the clinical evolution. We did not find any previous reports in the literature, on lung cancer with metastases concomitantly in the colon and thyroid, in a single patient.
authors.affiliation: Hospital AC Camargo, São Paulo, Brazil. carla.rameri@bol.com.br
authors.forename: Carla Rameri Alexandre Silva de
authors.initials: CR
authors.lastname: Azevedo
authors.forename: Loureno
authors.initials: L
authors.lastname: Cezana
authors.forename: Eduardo Sampaio Patrício de
authors.initials: ES
authors.lastname: Moraes
authors.forename: Maria Dirley Ferreira de Souza
authors.initials: MD
authors.lastname: Begnami
authors.forename: Tadeu Ferreira
authors.initials: TF
authors.lastname: Paiva Júnior
authors.forename: Aldo Lourenço Abbade
authors.initials: AL
authors.lastname: Dettino
authors.forename: Marcello Ferretti
authors.initials: MF
authors.lastname: Fanelli
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000556:secondary*; D003110:Colonic Neoplasms / Q000556:secondary*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D013964:Thyroid Neoplasms / Q000556:secondary*