TY - JOUR
T1 - Cardiac metastasis of squamous cell carcinoma of the thyroid gland with severe disseminated intravascular coagulation
T2 - A case report
AU - Yoshihiro, Tomoyasu
AU - Tsuchihashi, Kenji
AU - Kusaba, Hitoshi
AU - Nakashima, Torahiko
AU - Obara, Teppei
AU - Nio, Kenta
AU - Takayoshi, Kotoe
AU - Kodama, Hiroyuki
AU - Tsuruta, Nobuhiro
AU - Kiyohara, Hideyuki
AU - Asai, Kaori
AU - Harada, Eiji
AU - Kamezaki, Kenjiro
AU - Arita, Takeshi
AU - Sato, Masanobu
AU - Yamamoto, Hidetaka
AU - Arita, Shuji
AU - Ariyama, Hiroshi
AU - Odashiro, Keita
AU - Oda, Yoshinao
AU - Akashi, Koichi
AU - Baba, Eishi
PY - 2017/1
Y1 - 2017/1
N2 - Distant metastasis of primary squamous cell carcinoma (SCC) of the thyroid gland is rare and, to the best of our knowledge, cardiac metastasis has not been reported to date. A 57-year-old man underwent surgery and adjuvant chemoradiotherapy for stage IVA SCC of the thyroid gland. After 3 months, the patient was admitted to the Kyushu University Hospital (Fukuoka, Japan) with subcutaneous hematomas of the left thigh and lower leg, and he was diagnosed with cardiac and mediastinal lymph node metastases of SCC of the thyroid gland with severe disseminated intravascular coagulation (DIC). Echocardiography revealed a mass, 52 mm in greatest diameter, protruding from the interventricular septum towards the right ventricle. Weekly administration of paclitaxel and concurrent irradiation of the cardiac and lymph node metastases were performed. Eighteen days after the initiation of chemoradiotherapy, the DIC and hematomas had significantly improved, and the cardiac metastasis was stable. However, 2 months after admission, the patient developed dyspnea and multiple nodular shadows appeared to be spreading in the subpleura of the lungs bilaterally, which were initially suspected to be pulmonary tumor embolisms. Prednisolone and subsequent administration of lenvatinib were not effective and the patient succumbed to respiratory failure. Severe DIC caused by extremely rare cardiac metastasis of SCC of the thyroid gland was effectively controlled by chemoradiotherapy. However, intensive local control appears to be required for this condition.
AB - Distant metastasis of primary squamous cell carcinoma (SCC) of the thyroid gland is rare and, to the best of our knowledge, cardiac metastasis has not been reported to date. A 57-year-old man underwent surgery and adjuvant chemoradiotherapy for stage IVA SCC of the thyroid gland. After 3 months, the patient was admitted to the Kyushu University Hospital (Fukuoka, Japan) with subcutaneous hematomas of the left thigh and lower leg, and he was diagnosed with cardiac and mediastinal lymph node metastases of SCC of the thyroid gland with severe disseminated intravascular coagulation (DIC). Echocardiography revealed a mass, 52 mm in greatest diameter, protruding from the interventricular septum towards the right ventricle. Weekly administration of paclitaxel and concurrent irradiation of the cardiac and lymph node metastases were performed. Eighteen days after the initiation of chemoradiotherapy, the DIC and hematomas had significantly improved, and the cardiac metastasis was stable. However, 2 months after admission, the patient developed dyspnea and multiple nodular shadows appeared to be spreading in the subpleura of the lungs bilaterally, which were initially suspected to be pulmonary tumor embolisms. Prednisolone and subsequent administration of lenvatinib were not effective and the patient succumbed to respiratory failure. Severe DIC caused by extremely rare cardiac metastasis of SCC of the thyroid gland was effectively controlled by chemoradiotherapy. However, intensive local control appears to be required for this condition.
U2 - 10.3892/mco.2016.1091
DO - 10.3892/mco.2016.1091
M3 - Article
C2 - 28123737
SN - 2049-9450
VL - 6
SP - 91
EP - 95
JO - Molecular and Clinical Oncology
JF - Molecular and Clinical Oncology
IS - 1
ER -