Cardiac metastasis of squamous cell carcinoma of the thyroid gland with severe disseminated intravascular coagulation: A case report

Yoshihiro,Tomoyasu; Tsuchihashi,Kenji; Kusaba,Hitoshi; Nakashima,Torahiko; Obara,Teppei; Nio,Kenta; Takayoshi,Kotoe; Kodama,Hiroyuki; Tsuruta,Nobuhiro; Kiyohara,Hideyuki; Asai,Kaori; Harada,Eiji; Kamezaki,Kenjiro; Arita,Takeshi; Sato,Masanobu; Yamamoto,Hidetaka; Arita,Shuji; Ariyama,Hiroshi; Odashiro,Keita; Oda,Yoshinao; Akashi,Koichi; Baba,Eishi

doi:10.3892/mco.2016.1091

Cardiac metastasis of squamous cell carcinoma of the thyroid gland with severe disseminated intravascular coagulation: A case report

Authors:
- Tomoyasu Yoshihiro
- Kenji Tsuchihashi
- Hitoshi Kusaba
- Torahiko Nakashima
- Teppei Obara
- Kenta Nio
- Kotoe Takayoshi
- Hiroyuki Kodama
- Nobuhiro Tsuruta
- Hideyuki Kiyohara
- Kaori Asai
- Eiji Harada
- Kenjiro Kamezaki
- Takeshi Arita
- Masanobu Sato
- Hidetaka Yamamoto
- Shuji Arita
- Hiroshi Ariyama
- Keita Odashiro
- Yoshinao Oda
- Koichi Akashi
- Eishi Baba
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Affiliations: Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812‑8582, Japan, Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812‑8582, Japan, Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812‑8582, Japan, Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812‑8582, Japan, Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812‑8582, Japan, Department of Comprehensive Clinical Oncology, Faculty of Medical Sciences, Kyushu University, Fukuoka 812‑8582, Japan
Published online on: November 23, 2016 https://doi.org/10.3892/mco.2016.1091
Pages: 91-95

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Abstract

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.

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