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Popławska-Kita A, Wielogórska M, Poplawski Ł, et al. Thyroid carcinoma with atypical metastasis to the pituitary gland and unexpected postmortal diagnosis. Endocrinol Diabetes Metab Case Rep. 2020;2020doi: 10.1530/EDM-19-0148.
Popławska-Kita, A., Wielogórska, M., Poplawski, �. �., Siewko, K., Adamska, A., Szumowski, P., Myśliwiec, P., Myśliwiec, J., Reszeć, J., Kamiński, G., Dzięcioł, J., Tobiaszewska, D., Szelachowska, M., & Krętowski, A. J. (2020). Thyroid carcinoma with atypical metastasis to the pituitary gland and unexpected postmortal diagnosis. Endocrinology, diabetes & metabolism case reports, 2020. https://doi.org/10.1530/EDM-19-0148
Popławska-Kita, Anna, et al. "Thyroid carcinoma with atypical metastasis to the pituitary gland and unexpected postmortal diagnosis." Endocrinology, diabetes & metabolism case reports vol. 2020 (2020). doi: https://doi.org/10.1530/EDM-19-0148
Popławska-Kita A, Wielogórska M, Poplawski Ł, Siewko K, Adamska A, Szumowski P, Myśliwiec P, Myśliwiec J, Reszeć J, Kamiński G, Dzięcioł J, Tobiaszewska D, Szelachowska M, Krętowski AJ. Thyroid carcinoma with atypical metastasis to the pituitary gland and unexpected postmortal diagnosis. Endocrinol Diabetes Metab Case Rep. 2020 Mar 13;2020. doi: 10.1530/EDM-19-0148. Epub 2020 Mar 13. PMID: 32168468; PMCID: PMC7077587.
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Endocrinol Diabetes Metab Case Rep. 2020 Mar 13;2020. doi: 10.1530/EDM-19-0148. Epub 2020 Mar 13.

Thyroid carcinoma with atypical metastasis to the pituitary gland and unexpected postmortal diagnosis.

Endocrinology, diabetes & metabolism case reports

Anna Popławska-Kita, Marta Wielogórska, Łukasz Poplawski, Katarzyna Siewko, Agnieszka Adamska, Piotr Szumowski, Piotr Myśliwiec, Janusz Myśliwiec, Joanna Reszeć, Grzegorz Kamiński, Janusz Dzięcioł, Dorota Tobiaszewska, Małgorzata Szelachowska, Adam Jacek Krętowski

Affiliations

  1. Departments of Endocrinology, Diabetology and Internal Medicine.
  2. Radiology, Medical University of Bialystok, Bialystok, Poland.
  3. Departments of Nuclear Medicine, Medical University of Bialystok, Bialystok, Poland.
  4. 1st Clinic Department of General and Endocrine Surgery, Medical University of Bialystok, Bialystok, Poland.
  5. Departments of Medical Pathomorphology, Medical University of Bialystok, Bialystok, Poland.
  6. Department of Endocrinology and Radioisotopy Therapy, Military Institute of Medicine, Warsaw, Poland.
  7. Departments of Human Anatomy, Medical University of Bialystok, Bialystok, Poland.

PMID: 32168468 PMCID: PMC7077587 DOI: 10.1530/EDM-19-0148

Abstract

SUMMARY: Papillary thyroid gland carcinoma is the most common type of malignancy of the endocrine system. Metastases to the pituitary gland have been described as a complication of papillary thyroid cancer in few reported cases since 1965. We report the case of a 68-year-old female patient with a well-differentiated form of thyroid gland cancer. Despite it being the most common malignant cancer of the endocrine system, with its papillary form being one of the two most frequently diagnosed thyroid cancers, the case we present is extremely rare. Sudden cardiac arrest during ventricular fibrillation occurred during hospitalization. Autopsy of the patient revealed papillary carcinoma of the thyroid, follicular variant, with metastasis to the sella turcica, and concomitant sarcoidosis of heart, lung, and mediastinal and hilar lymph nodes. Not only does atypical metastasis make our patient's case most remarkable, but also the postmortem diagnosis of sarcoidosis makes her case particularly unusual.

LEARNING POINTS: The goal of presenting this case is to raise awareness of the clinical heterogeneity of papillary cancer and promote early diagnosis of unexpected metastasis and coexisting diseases to improve clinical outcomes. Clinicians must be skeptical. They should not fall into the trap of diagnostic momentum or accept diagnostic labels at face value. Regardless of the potential mechanisms, clinicians should be aware of the possibility of the coexistence of thyroid cancer and sarcoidosis as a differential diagnosis of lymphadenopathy. This case highlights the importance of the diagnostic and therapeutic planning process and raises awareness of the fact that one uncommon disease could be masked by another extremely rare disorder.

Keywords: 2020; Adult; Bromocriptine; CT scan; Corticosteroids; Cytokeratin 7*; Diplopia; Dizziness; Dopamine agonists; FSH; Female; Fine needle aspiration biopsy; Glucocorticoids; Goitre; Goitre (multinodular); Granuloma; Headache; Heart failure; Histopathology; Hydrocortisone; Hyperprolactinaemia; Hyponatraemia; Hypopituitarism; Immunohistochemistry; LH; Levothyroxine; Lymph node dissection; Lymphadenitis; Lymphadenopathy; MRI; March; Metastatic carcinoma; Mineralocorticoids; Normochromic normocytic anaemia; Oculomotor nerve palsies*; Papillary thyroid cancer; Paraesthesia; Pituitary adenoma; Pituitary function; Poland; Prolactin; Ptosis; Radionuclide imaging; Recombinant TSH*; Resection of tumour; Sarcoidosis; Sarcoidosis*; Sodium chloride; Surgery; TSH; Thyroglobulin; Thyroid; Thyroid antibodies; Thyroid carcinoma; Thyroid transcription factor-1; Thyroid ultrasonography; Thyroidectomy; Transsphenoidal surgery; Ultrasound scan; Unique/unexpected symptoms or presentations of a disease; Ventricular fibrillation; Vision - acuity reduction; Visual impairment; Vomiting; White

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