Papillary thyroid carcinoma revealed by renal metastasis: Case report and review of the literature

Differentiated thyroid cancer is the first endocrine cancer but remains rare, representing only 1% of neoplastic pathologies. Its discovery at the occasion of distant metastasis is even rarer but not exceptional.

We report the case of a 50-year-old woman with a papillary thyroid carcinoma in its vesicular variant revealed by renal metastasis at the anatomopathology of the nephrectomy specimen.

The review of the literature shows that vesicular cancer is the most frequent in cases of revealed metastasis.  Etiopathogenically, renal involvement occurs mainly via the hematogenous route, rarely via the lymphatic route.

The treatment of metastatic CTD requires a multidisciplinary approach. In the presence of metastases revealing thyroid carcinoma, thyroidectomy is required, followed by lymph node dissection and isotopic treatment with iodine 131, which allows a white cervical map to be obtained with the direct destruction of iodine-binding metastases, followed by hormone therapy to slow down the thyroid axis.  The treatment of metastases will depend on their location and characteristics.

The prognosis of differentiated thyroid carcinoma is very favorable, but worsens when it is revealed by a distant metastasis.

Survival is significantly better for patients with small volume and iodine-binding metastases.