case_images: PMC10895323_01
case_images: Thyroid US presentation in 2022 (A) and 1 year later (B). The complete changes of the echo-structure and the rapid increase of thyroid size are impressive.
case_images: EDM23-0126fig1.jpg
case_images: PMC10895323_01_EDM23-0126fig1.jpg
case_images: fig1
case_images: T4, with negative anti-thyroid antibodies. Thyroid US performed during that visit revealed a homogeneous echo-structure and a volume within the normal range for her gender and weight (Fig. 1A). This patient's medical history included a diagnosis of RCC in December 2015, specifically the papillary type with Fuhrman grade 3, staged as T2a R0, and successfully treated with a radical left nephrectomy. Subsequently, a thyroid US was performed, which revealed a conspicuous hypoechoic mass encompassing the entire thyroid gland (Fig. 1B).
case_images: (A) CT-scan performed at the end of July with contrast agent shows the thyroid gland slightly enlarged with slight inhomogeneity of the structure. (B) CT-scan performed with contrast agent, 5 days later, shows the enlarged thyroid gland with a nonhomogeneous structure, with hypodense areas, which surrounds the trachea.
case_images: EDM23-0126fig2.jpg
case_images: PMC10895323_01_EDM23-0126fig2.jpg
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case_images: In July 2023, in CT scan performed during the annual oncological follow-up, the neck region was initially described as showing signs of inflammation, with thyroid involvement (Fig. 2).
case_images: (A) The formalin-fixed, paraffin-embedded cell block sections showing isolated or in papillary structures cells with enlarged nuclei, with granular chromatin and moderately represented cytoplasm. (B and C) Immunohistochemistry showing strong, diffuse nuclear immunoreactivity for PAX8 and cytoplasmic immunoreactivity for CK19 in the tumor (A, hematoxylin-eosin-stained cell block, original magnifications 20x; B and C, original magnifications 20x).
case_images: EDM23-0126fig3.jpg
case_images: PMC10895323_01_EDM23-0126fig3.jpg
case_images: fig3
case_images: Cytological analysis demonstrated the presence of malignant cells suspicious for metastatic lesion originating from the RCC (Fig. 3).