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Unusual presentation of more common disease/injury
CASE REPORT
Unilateral adrenal mass as the sole initial manifestation of differentiated thyroid cancer
  1. Geethalakshmi Sampathkumar1,
  2. Arun S Menon1,
  3. Bindhu M R2,
  4. Vasantha Nair1
  1. 1Department of Endocrinology and Metabolism, Amrita Institute of Medical Sciences and Research Centre, Cochin, Kerala, India
  2. 2Department of Pathology, Amrita Institute of Medical Sciences and Research Centre, Cochin, Kerala, India
  1. Correspondence to Dr Geethalakshmi Sampathkumar, drgeethalakshmi86{at}gmail.com

Summary

Unilateral adrenal metastases without disseminated disease has rarely been reported in differentiated thyroid carcinoma (DTC). A 72-year-old female presented with vague abdominal discomfort and loss of appetite of 2 months duration. She had undergone left hemithyroidectomy for a benign thyroid nodule 18 years ago. A contrast CT of the abdomen showed a large left adrenal mass measuring 11×9 cm, suspicious of adrenocortical carcinoma. Hormonal evaluation was in keeping with a non-functional tumour. The patient underwent left adrenalectomy, histopathology of which revealed metastatic well-differentiated thyroid carcinoma. Ultrasound of thyroid done postoperatively showed a subcentimetric hypoechoic lesion with increased vascularity and microcalcifications in the right thyroid bed. Histopathology from a completion thyroidectomy specimen was consistent with follicular variant of papillary thyroid carcinoma. She was treated with high-dose radioiodine ablation therapy and has remained disease-free on follow-up for more than a year.

  • thyroid disease
  • endocrine cancer

https://doi.org/10.1136/bcr-2017-221296

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    Footnotes

    • Contributors GS and BMR contributed to the conception, design, analysis and interpretation of the data. ASM and VN were responsible for the drafting the article and the final approval of the version to be published. ASM was involved in revising the manuscript critically for important intellectual content. All authors read and approved the final manuscript.

    • Disclaimer I, GS, on behalf of all authors confirm that this work is original and also verify that all the authors have made a significant contribution to the findings in this case report. I certify that neither this manuscript nor one with substantially similar content under my authorship has been published or is being considered for publication elsewhere.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.