Thyroid cancers exist in multiple forms. Papillary and follicular carcinomas of the thyroid are often referred to as well-differentiated thyroid cancers. Well-differentiated thyroid cancers rarely present as a distant metastatic cancer on initial diagnosis. Papillary thyroid cancer tends to have a good prognosis; however, if distant metastasis of PTC is present, there is usually a poor clinical outcome with a less favorable prognosis. In this study, we report a 90-year-old female who presented with right-sided abdominal discomfort. A renal ultrasound revealed bilateral upper pole renal masses. A percutaneous biopsy was ordered, and the microscopic examination revealed bilateral renal metastasis with a follicular variant of papillary thyroid carcinoma. The patient underwent thyroidectomy and sustained radiation therapy for her bilateral renal metastases. She died 6 years after her initial diagnosis, due to sepsis. This is the second study in literature to report bilateral renal metastasis of follicular variant of papillary thyroid cancer.
SchneiderDFChenH. New developments in the diagnosis and treatment of thyroid cancer. CA Cancer J Clin. 2013;63(6):374-394.
2.
FalzaranoSMChuteDJMagi-GalluzziC. Metastatic papillary thyroid carcinoma to the kidney: report of two cases mimicking primary renal cell carcinoma and review of the literature. Pathology. 2013;45(1):89-93.
3.
KumarANadigMPatraV, et al.Adrenal and renal metastases from follicular thyroid cancer. Br J Radiol. 2005;78(935):1038-1041.
4.
CochettiGPuxedduEZingaroMD, et al.Laparoscopic partial nephrectomy of thyroid cancer metastasis: case report and review of the literature. Onco Targets Ther. 2013;6:355-360. Published 2013 Apr 10.
5.
VarinotJMénégauxFBitkerMO, et al.Renal metastasis from thyroid carcinoma: a case report. Anal Quant Cytopathol Histpathol. 2014;36(1):46-50.
6.
LubanaSSSinghNTuliSS, et al.Follicular variant of papillary thyroid cancer with bilateral renal metastases discovered incidentally during work-up of primary endometrial cancer: a rare occurrence. Am J Case Rep. 2015;16:459-468. Published 2015 Jul 16.
7.
BalochZWLiVolsiVA. Diagnostic dilemmas in thyroid pathology: follicular variant of papillary thyroid carcinoma and classic papillary thyroid carcinoma arising in lymphocytic thyroiditis. Pathol Case Rev.2003;8(1):47-56.
8.
AmendoeiraIMaiaTSobrinho-SimõesM. Non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP): impact on the reclassification of thyroid nodules. Endocr Relat Cancer. 2018;25(4):R247-R258.
9.
KiernanCMWeissVLMehradM, et al.New terminology-noninvasive follicular neoplasm with papillary-like nuclear features (NIFTP) and its effect on the rate of malignancy at a single institution. Surgery. 2018;163(1):55-59.
10.
SalajeghehAPetcuEBSmithRA, et al.Follicular variant of papillary thyroid carcinoma: a diagnostic challenge for clinicians and pathologists. Postgrad Med J. 2008;84(988):78-82.
11.
PusztaszeriMBongiovanniM. The impact of non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) on the diagnosis of thyroid nodules. Gland Surg. 2019;8(Suppl 2):S86-S97.
12.
ZhuZGandhiMNikiforovaMN, et al.Molecular profile and clinical-pathologic features of the follicular variant of papillary thyroid carcinoma. An unusually high prevalence of ras mutations. Am J Clin Pathol. 2003;120(1):71-77.
13.
MainthiaRWachtelHChenY, et al.Evaluating the projected surgical impact of reclassifying noninvasive encapsulated follicular variant of papillary thyroid cancer as noninvasive follicular thyroid neoplasm with papillary-like nuclear features. Surgery. 2018;163(1):60-65.
14.
WoodWJJrSingletarySEHickeyRC. Current results of treatment for distant metastatic well-differentiated thyroid carcinoma. Arch Surg. 1989;124(12):1374-1377.
15.
MadaniAJozaghiYTabahR, et al.Rare metastases of well-differentiated thyroid cancers: a systematic review. Ann Surg Oncol. 2015;22(2):460-466.
16.
AbeKHasegawaTOnoderaS, et al.Renal metastasis of thyroid carcinoma. Int J Urol. 2002;9(11):656-658.
17.
SongHJXueYLXuYH, et al.Rare metastases of differentiated thyroid carcinoma: pictorial review. Endocr Relat Cancer. 2011;18(5):R165-R174. Published 2011 Aug 30.
18.
Chen-KuCHRoldánB. Unusual papillary thyroid cancer metastases to kidney and pharynx: a case report. AACE Clinical Case Reports. 2016;2(2):e86-e90.
19.
CheungCCEzzatSFreemanJL, et al.Immunohistochemical diagnosis of papillary thyroid carcinoma. Mod Pathol. 2001;14(4):338-342.
20.
BishopJASharmaRIlleiPB. Napsin A and thyroid transcription factor-1 expression in carcinomas of the lung, breast, pancreas, colon, kidney, thyroid, and malignant mesothelioma. Hum Pathol. 2010;41(1):20-25.
21.
LauryARPeretsRPiaoH, et al.A comprehensive analysis of PAX8 expression in human epithelial tumors. Am J Surg Pathol. 2011;35(6):816-826.
22.
SrigleyJRDelahuntBEbleJN, et al.The International Society of Urological Pathology (ISUP) Vancouver Classification of renal neoplasia. Am J Surg Pathol. 2013;37(10):1469-1489.
23.
MochHCubillaALHumphreyPA, et al.The 2016 WHO classification of tumours of the urinary system and male genital organs-part A: renal, penile, and testicular tumours. Eur Urol. 2016;70(1):93-105.
24.
EbleJNDelahuntB. Emerging entities in renal cell neoplasia: thyroid-like follicular renal cell carcinoma and multifocal oncocytoma-like tumours associated with oncocytosis. Pathology. 2018;50(1):24-36.
25.
Al-ObaidyKIBridgeJAChengL, et al.EWSR1-PATZ1 Fusion renal cell carcinoma: a recurrent gene fusion characterizing thyroid-like follicular renal cell carcinoma. Mod Pathol. 2021;34(10):1921-1934.
26.
MehraRSmithSCDivatiaM, et al.Emerging entities in renal neoplasia. Surg Pathol Clin. 2015;8(4):623-656.
27.
FanelliGNFassanMDal MoroF, et al.Thyroid-like follicular carcinoma of the kidney: the mutational profiling reveals a BRAF wild type status. Pathol Res Pract. 2019;215(9):152532.
28.
AminMBGuptaROndrejH, et al.Primary thyroid-like follicular carcinoma of the kidney: report of 6 cases of a histologically distinctive adult renal epithelial neoplasm. Am J Surg Pathol. 2009;33(3):393-400.
29.
NikiforovaMNLynchRABiddingerPW, et al.RAS Point mutations and PAX8-PPAR gamma rearrangement in thyroid tumors: evidence for distinct molecular pathways in thyroid follicular carcinoma. J Clin Endocrinol Metab. 2003;88(5):2318-2326.
30.
HaugenBRAlexanderEKBibleKC, et al.2015 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association Guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26(1):1-133.
31.
RajjoubSRYanHCalcateraNA, et al.Thyroid lobectomy is not sufficient for T2 papillary thyroid cancers. Surgery. 2018;163(5):1134-1143.
32.
NguyenQTLeeEJHuangMG, et al.Diagnosis and treatment of patients with thyroid cancer. Am Health Drug Benefits. 2015;8(1):30-40.
33.
GaoYDengWChenY, et al.Renal metastases as the initial presentation of papillary thyroid carcinoma: a case report and literature review. Mol Clin Oncol. 2017;6(6):821-824.
