Case report

Metastatic Hurthle Cell Carcinoma of the thyroid presenting as a Breast Lump: A Case Report

Yahya Al-Abed¹, Emma Gray¹, Konrad Wolfe², Gavin W Watters³ and Jonathan M Philpott³

¹  The Breast Unit, Department of Surgery, Southend University Hospital, Prittlewell Chase, Westcliff-on-Sea, Essex SS0 0RY, UK

²  Department of Histopathology, Southend University Hospital, Prittlewell Chase, Westcliff-on-Sea, Essex SS0 0RY, UK

³  Department of Ear, Nose and Throat, Southend University Hospital, Prittlewell Chase, Westcliff-on-Sea, Essex SS0 0RY, UK

International Seminars in Surgical Oncology 2008, 5:14doi:10.1186/1477-7800-5-14

Published:	27 May 2008

Abstract

Background

Hurthle cell carcinoma of the thyroid is a rare form of thyroid cancer. It may present as a low grade tumour or can present as a more aggressive metastatic carcinoma. Hurthle cell carcinoma has the highest incidence of metastasis among all differentiated thyroid cancers. Most commonly haematogenous spread to lungs, bones and brain, however spread to regional lymph nodes is not uncommon. The breast is a rare site for metastasis from extramammary sources. We present the first case of breast metastasis from Hurthle cell carcinoma of the thyroid.

Case presentation

We report a 77 year old lady who had total thyroidectomy and bilateral neck dissection followed by radiotherapy for a high grade metastatic Hurthle cell carcinoma of the thyroid. Ten months later she presented to the breast clinic with left breast lump and a lump at the left axilla. Fine needle aspiration cytology of the lumps and histology after wide local excision of the breast lump confirmed metastatic Hurthle cell carcinoma.

Conclusion

The presence of breast lumps in patients with history of extramammary cancer should raise the possibility of metastasis.