Synchronous thyroid gland metastases from breast cancer. Case reports

Abstract

Background. Breast cancer is the leading cause of death in women. Distant metastases in different organs, including the thyroid gland, are still an urgent problem. Distant metastases are very rare in clinical practice. Nevertheless, the accumulated clinical and surgical experience in treatment has shown that breast cancer is the second most common primary tumor, leading to thyroid gland metastases, after kidney cancer.
 Aim. Present the clinical observations of synchronous thyroid gland metastases from breast cancer.
 Materials and methods. We observed two patients, aged 55 and 72 years, suffering from metastatic breast cancer with simultaneous metastases to the thyroid gland, to the cervical and mediastinal lymph nodes, to the lungs, to the ovaries and to the bones.
 Results. A 55-year-old woman with a left sided neck mass and hoarseness has been suffering from the metastatic breast cancer with simultaneous metastases to the thyroid gland, to the cervical lymph nodes, to the lungs, to the ovaries and to the bones. The biopsy of the primary tumor has been performed. The tumor has the structure of invasive ductal carcinoma, G2, luminal A subtype, HER2-negative type in histological and immunohistochemical analysis. The spread of the tumor has been determined by positron emission tomography/computed tomography (PET/CT). Metastases from breast cancer have been cytologically proven during thin needle biopsy. A 72-year-old woman with a mass in the region of thyroid gland has been suffering from breast cancer with metastases to the thyroid gland, to the mediastinal and cervical lymph nodes, to the bones, and to determine this process PET/CT, the thyroid fine needle aspiration biopsy and core biopsy of primary tumor have been applied. The histological variant was represented by invasive ductal cancer, G2, luminal A subtype, HER-2 negative type. Taking into account the spread of the process, the patients were given polychemotherapy, targeted therapy and hormone therapy. There is no disease progression for 6 months.
 Conclusion. Synchronous thyroid gland metastases in case of primary breast tumors are rare. In such cases, PET/CT is the important diagnostic method. The main therapeutic option in this case is systemic therapy, including chemotherapy, targeted and hormone therapy, the nature of the agent depends on the biological variant of the tumor.