case_images: PMC3880721_01
case_images: Lung lobectomy: hematoxylin and eosin stain of the pathologic specimen from left upper lobectomy showing poorly differentiated adenocarcinoma, H&E.
case_images: CRIM.ONCMED2013-208213.001.jpg
case_images: PMC3880721_01_CRIM.ONCMED2013-208213.001.jpg
case_images: fig1
case_images: Histopathological examination of the tumor confirmed poorly differentiated adenocarcinoma (Figure 1).
case_images: Neck CT: A reveals a large heterogeneous mass that has replaced the left lobe of the thyroid gland.
case_images: CRIM.ONCMED2013-208213.002.jpg
case_images: PMC3880721_01_CRIM.ONCMED2013-208213.002.jpg
case_images: fig2
case_images: Neck computed tomography (CT) showed interval enlargement of a heterogeneously enhancing mass in the left thyroid lobe (Figure 2).
case_images: Fine needle aspiration of the thyroid mass FNA, ThinPrep shows clusters of cancer cells with large nuclei and prominent nucleoli, consistent with metastatic lung adenocarcinoma.
case_images: CRIM.ONCMED2013-208213.003.jpg
case_images: PMC3880721_01_CRIM.ONCMED2013-208213.003.jpg
case_images: fig3
case_images: TTF-1 and negative for thyroglobulin, consistent with metastatic disease from lung origin (Figure 3). The patient was evaluated for thyroidectomy; nevertheless, because of the presence of positron emission tomography (PET) positive mediastinal lymph nodes that were hypermetabolic (Figure 4), she was deemed a nonsurgical candidate.
case_images: Fused fluorodeoxyglucose (FDG) positron emission tomography (PET) CT shows hypermetabolic left supraclavicular lymphadenopathy (yellow).
case_images: CRIM.ONCMED2013-208213.004.jpg
case_images: PMC3880721_01_CRIM.ONCMED2013-208213.004.jpg
case_images: fig4
case_images: TTF-1 and negative for thyroglobulin, consistent with metastatic disease from lung origin (Figure 3). The patient was evaluated for thyroidectomy; nevertheless, because of the presence of positron emission tomography (PET) positive mediastinal lymph nodes that were hypermetabolic (Figure 4), she was deemed a nonsurgical candidate.