title: Thyroid Metastasis of Gastric Cancer: A Rare Occasion With Poor Prognosis.
abstract: A 68-year-old man was diagnosed as having advanced gastric cancer. Computed tomography showed a thyroid tumor with trachea deviation. This tumor exhibited mosaic echogenecity in ultrasonography. Signet-ring cell carcinoma was found by means of fine needle aspiration biopsy. This tumor gradually became swollen and the thyroid hormone levels in blood were increased without any clinical symptom. Shortly, he died from his illness in the 29th hospital day. Autopsy disclosed that the left lobe of the thyroid gland was highly invaded by malignant cells and that lymphogenic rather than angiogenic metastasis was highly probable. Thyroid metastasis of gastric cancer is extremely rare. The prognosis is very poor. Ultrasonography is a very useful modality especially when coupled with recently developed fine needle aspiration biopsy in differential diagnosis of thyroid tumors once malignancy is suspected. Therapeutic strategy largely depends on the nature of primary malignant tumor. If the tumor is slowly progressive such as renal cell carcinoma and breast cancer, extirpation of thyroid tumors may extend life expectancy. In conclusion, the metastatic thyroid tumor of gastric cancer is rare and shows poor prognosis. Fine needle aspiration biopsy under ultrasonography is strongly recommended as a useful diagnostic tool.
authors.affiliation: Division of Gastroenterology and Hepatology, Nagaoka Red Cross Hospital, Japan.
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Miura
authors.affiliation: Division of Gastroenterology and Hepatology, Nagaoka Red Cross Hospital, Japan.
authors.forename: Junichiro
authors.initials: J
authors.lastname: Nakamura
authors.affiliation: Division of Diabetes and Endocrinology, Nagaoka Red Cross Hospital, Japan.
authors.forename: Keita
authors.initials: K
authors.lastname: Kimura
authors.affiliation: Division of Diabetes and Endocrinology, Nagaoka Red Cross Hospital, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamada
authors.affiliation: Division of Diabetes and Endocrinology, Nagaoka Red Cross Hospital, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Miura
authors.affiliation: Division of Gastroenterology and Hepatology, Nagaoka Red Cross Hospital, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Yanagi
authors.affiliation: Division of Nephrology, Nagaoka Red Cross Hospital, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Yamazaki
authors.affiliation: Division of Medical Technology, Nagaoka Red Cross Hospital, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Usuda
authors.affiliation: Division of Pathology, Nagaoka Red Cross Hospital, Japan.
authors.forename: Iwao
authors.initials: I
authors.lastname: Emura
authors.affiliation: Division of Gastroenterology and Hepatology, Nagaoka Red Cross Hospital, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Takahashi
keywords: Fine needle aspiration biopsy; Gastric cancer; Thyroid metastasis