MOLECULAR AND CLINICAL ONCOLOGY 6: 91-95, 2017
Cardiac metastasis of squamous cell carcinoma of the thyroid gland with severe disseminated intravascular coagulation: A case report TOMOYASU YOSHIHIRO1, KENJI TSUCHIHASHI1, HITOSHI KUSABA1, TORAHIKO NAKASHIMA2, TEPPEI OBARA1, KENTA NIO1, KOTOE TAKAYOSHI1, HIROYUKI KODAMA1, NOBUHIRO TSURUTA1, HIDEYUKI KIYOHARA2, KAORI ASAI3, EIJI HARADA4, KENJIRO KAMEZAKI1, TAKESHI ARITA1, MASANOBU SATO5, HIDETAKA YAMAMOTO5, SHUJI ARITA6, HIROSHI ARIYAMA1, KEITA ODASHIRO1, YOSHINAO ODA5, KOICHI AKASHI1 and EISHI BABA6 Departments of 1Medicine and Biosystemic Science, 2Otorhinolaryngology and 3Clinical Radiology; 4 Research Institute for Diseases of the Chest; 5Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences; 6Department of Comprehensive Clinical Oncology, Faculty of Medical Sciences, Kyushu University, Fukuoka 812‑8582, Japan Received August 29, 2016; Accepted October 21, 2016 DOI: 10.3892/mco.2016.1091 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
Correspondence to: Professor Eishi Baba, Department of
Comprehensive Clinical Oncology, Faculty of Medical Sciences, Kyushu University, 3‑1‑1 Maidashi, Higashi‑ku, Fukuoka 812‑8582, Japan E‑mail: e‑baba@c‑oncology.med.kyushu‑u.ac.jp
Key words: squamous cell carcinoma of the thyroid gland, cardiac metastasis, chemoradiotherapy
disseminated
intravascular
coagulation,
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. Introduction Primary squamous cell carcinoma (SCC) of the thyroid gland is rare, accounting for
Cardiac metastasis of squamous cell carcinoma of the thyroid gland with severe disseminated intravascular coagulation: A case report TOMOYASU YOSHIHIRO1, KENJI TSUCHIHASHI1, HITOSHI KUSABA1, TORAHIKO NAKASHIMA2, TEPPEI OBARA1, KENTA NIO1, KOTOE TAKAYOSHI1, HIROYUKI KODAMA1, NOBUHIRO TSURUTA1, HIDEYUKI KIYOHARA2, KAORI ASAI3, EIJI HARADA4, KENJIRO KAMEZAKI1, TAKESHI ARITA1, MASANOBU SATO5, HIDETAKA YAMAMOTO5, SHUJI ARITA6, HIROSHI ARIYAMA1, KEITA ODASHIRO1, YOSHINAO ODA5, KOICHI AKASHI1 and EISHI BABA6 Departments of 1Medicine and Biosystemic Science, 2Otorhinolaryngology and 3Clinical Radiology; 4 Research Institute for Diseases of the Chest; 5Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences; 6Department of Comprehensive Clinical Oncology, Faculty of Medical Sciences, Kyushu University, Fukuoka 812‑8582, Japan Received August 29, 2016; Accepted October 21, 2016 DOI: 10.3892/mco.2016.1091 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
Correspondence to: Professor Eishi Baba, Department of
Comprehensive Clinical Oncology, Faculty of Medical Sciences, Kyushu University, 3‑1‑1 Maidashi, Higashi‑ku, Fukuoka 812‑8582, Japan E‑mail: e‑baba@c‑oncology.med.kyushu‑u.ac.jp
Key words: squamous cell carcinoma of the thyroid gland, cardiac metastasis, chemoradiotherapy
disseminated
intravascular
coagulation,
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. Introduction Primary squamous cell carcinoma (SCC) of the thyroid gland is rare, accounting for
