A 61-year-old woman with a history of hysterectomy plus double adnexectomy for uterine fibroids in 1997, hiatal hernia, and hypertension treated medically.
He also had a thyroid nodule of 3 cm in diameter, diagnosed with nodular colloid goiter by FNAB in 1995.
She underwent right radical nephrectomy in 2001, due to a heterogeneous tumor of 8 cm in diameter located at the middle third of the right kidney, corresponding to the posterior pathological study, high-grade renal adenocarcinoma NonMoT stage renal vein, stage p.
It was subsequently treated as an adjunct to subcutaneous interleukin-2 for 12 months.
1.
The macroscopic anatomopathological report of the specimen described a tumoral nodule involving the pelvis and renal vein, with a diameter of 8 x 5 x 7 cm, combining greyish areas with other brownish areas
In the microscopic study, a pseudotumour corresponding to high grade renal adenocarcinoma was observed, with some zone a.
The tumour located in the foot-local system showed evidence of vascular invasion.
Surgical margins were free.
In 2004 in a control study, a marked growth of the left thyroid lobe was detected by CT, with the presence of a heterogeneous 4 cm nodule in relation to the previously known colloid nodule.
In 2005, a new CT scan showed a nodule growth up to 5.6 cm in the same left thyroid lobe displacing the trachea.
Thyroid scintigraphy showed a 'cold nodule' in the left lobe, while blood analysis showed no alteration in thyroid hormone levels.
1.
The progressive growth of the nodule was decided to perform left hemithyroidectomy.
The anatomopathological report described a left hemithyroid with a nodule of 8 x 6 x 2 cm, with multiple nodules located on the surface, alternating with other more expensive zones.
Microscopic examination revealed a lesion consisting of tumor cells with clear cytoplasm, which showed a marked atypia, with areas including tapered pancreas and the presence of mitotic figures.
Diffuse growth was observed in nodules with extensive areas of necrosis.
The lesion was surrounded by respected thyroid tissue in which lymphoid follicles were observed.
Immunohistochemical techniques were performed in which these tumor cells showed negativity for thyroglobulin and positivity for CK8, CK18, EMA, and Vimentin.
Given the histological characteristics of the tumor and the immunohistochemical profile, together with the clinical history of the patient, the lesion was reported as metastasis of clear cell renal adenocarcinoma.
