Renal Rupture Associated with a Poorly Differentiated Follicular Thyroid Carcinoma Metastasizing to the Thigh Muscle, Lung and Kidney

• Published in: Internal Medicine Vol. 44; no. 8; pp. 848 - 852
• Main Authors: IWAI, Hiroshi, OHNO, Yasuhiro, ITO, Hiroyuki, KIYOKAWA, Tomomi, AOKI, Norihiko
• Format: Journal Article
• Language: English
• Published: Tokyo The Japanese Society of Internal Medicine 01.08.2005; Japanese Society of Internal Medicine
• Subjects: Adenocarcinoma, Follicular - complications; Adenocarcinoma, Follicular - pathology; Adenocarcinoma, Follicular - secondary; Aged; Biological and medical sciences; distant metastases; Female; follicular thyroid carcinoma; General aspects; Humans; Injuries of the urinary system. Foreign bodies. Diseases due to physical agents; Kidney Diseases - etiology; Kidney Neoplasms - pathology; Kidney Neoplasms - secondary; Lung Neoplasms - pathology; Lung Neoplasms - secondary; Medical sciences; Muscle Neoplasms - pathology; Muscle Neoplasms - secondary; p53 antibody; renal rupture; Rupture, Spontaneous; Thigh; Thyroid Neoplasms - complications; Thyroid Neoplasms - pathology; Time Factors; Traumas. Diseases due to physical agents; Endocrinopathy; Kidney disease; Urinary system disease; Internal medicine; Thigh; Lung; Thyroid diseases; Malignant tumor; Metastasis; Follicular carcinoma; Thyroid carcinoma; Association; Thyroid cancer; Muscle; Kidney rupture
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.44.848

A 76-year-old woman with a history of total thyroidectomy for a thyroid carcinoma at the age of 63 was admitted to our hospital for the treatment of a renal rupture induced by a tumor of about 3 cm in diameter. High levels of blood thyroglobulin (Tg >1,000 ng/ml) led us to suspect a recurrence of thyroid carcinoma. Strong accumulation in whole-body 123I and 201Tl scintigraphy scans after the nephrectomy revealed tumors in the right lung and left thigh muscle measuring 5 cm and 9 cm in diameter, respectively. The tumors of the kidney and thigh muscle were pathologically diagnosed as poorly differentiated follicular thyroid carcinoma, and the lung tumor was also suggested to be a metastasis of the thyroid carcinoma based on the scintigraphy findings. We report this rare case of follicular thyroid carcinoma associated with metastases to the thigh muscle and kidney leading to a rupture 13 years after a total thyroidectomy. Care should be taken to determine whether unknown tumors are thyroid carcinoma metastases.