Medullary Thyroid Carcinoma Metastatic to the Breast: Case Report

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Amal Halim
Eman M. Ibrahim
Fatma I. El-saeed
Enas A. Abd Elgalil
Hosam Halim


Aims: To spot the light on metastatic tumors to the breast which represent only 0.5-1.5% of breast malignancies to avoid misdiagnosis as primary breast tumors. 

Presentation of the Case: 45-year-old female was referred to the Oncology Department of Meet Ghmmr Oncology Center in November 2017 after total thyroidectomy followed by cervical lymph node dissection for medullary thyroid carcinoma (MTC) 1 year ago at Oncology Center Mansoura University. The panel recommended postoperative radiotherapy. One month after the end of radiotherapy, she complained of frequent headache attacks and abdominal pain. CT was done in February 2018 revealed metastasis to the brain, lung, liver and ovaries. After the fifth cycle of chemotherapy, a progressively enlarging left breast mass appeared, that proved to be metastatic MTC.

Discussion: MTC is a neuroendocrine tumor of the thyroid gland. Breast is an unusual metastatic site for MTC. Consequently, breast masses should be evaluated with caution, especially in the presence of a known primary malignancy. Histopathologic examination is the key diagnostic tool.

Conclusion: Metastasis to the breast should be considered in the differential diagnosis of a breast mass in a patient with a past history of MTC. Histopathologic examination and proper panel of immunohistochemical markers are fundamental for diagnosis to prevent unneeded surgery.

Thyroid, breast, medullary, metastasis, carcinoma.

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How to Cite
Halim, A., M. Ibrahim, E., El-saeed, F. I., Elgalil, E., & Halim, H. (2019). Medullary Thyroid Carcinoma Metastatic to the Breast: Case Report. Journal of Cancer and Tumor International, 9(3), 1-6.
Case study


Akcay MN. Metastatic disease in the breast. The Breast. 2002;11(6):526-8.

Hajdu SI, Urban JA. Cancers metastatic to the breast. Cancer. 1972;29(6):1691-6.

Di Bonito L, Luchi M, Giarelli L, Falconieri G, Viehl P. Metastatic tumors to the female breast: An autopsy study of 12 cases. Pathology-Research and Practice. 1991; 187(4):432-6.

Magers MJ, Dueber JC, Lew M, Pang JC, Davenport RD. Metastatic ductal carcinoma of the breast to the thyroid gland diagnosed with fine needle aspiration: A case report with emphasis on morphologic and immunophenotypic features. Diagnostic Cytopathology. 2016; 44(6):530-4.

Gajdzis M, Cassoux N, Lesnik M, Hoffmann C, Badois N, Gajdzis P, Klijanienko J. Intraocular metastasis of medullary thyroid carcinoma investigated by transscleral fine‐needle aspiration. A case report and review of the literature. Diagnostic Cytopathology. 2018;46(9): 764-8.

Pacini F, Castagna MG, Cipri C, Schlumberger M. Medullary thyroid carcinoma. Clinical Oncology. 2010;22(6): 475-85.

Lupone G, Antonino A, Rosato A, Zenone P, Iervolino E, Grillo M, De Palma M. Surgical strategy for the treatment of sporadic medullary thyroid carcinoma: Our experience. Il Giornale di Chirurgia. 2012; 33(11/12):395-9.

Meng K, Luo H, Chen H, Guo H, Xia W. Prognostic value of numbers of metastatic lymph node in medullary thyroid carcinoma: A population-based study using the SEER 18 database. Medicine. 2019; 98(1).

Mandanas S, Margaritidou E, Christoforidou V, Karoglou E, Geranou C, Chrisoulidou A, Boudina M, Georgopoulos K, Pazaitou-Panayiotou K. Breast metastasis from medullary thyroid carcinoma in a male patient: Case report and review of the literature. Rare Tumors. 2015;18;7(2):60-3.

Ali SZ, Teichberg S, Attie JN, Susin M. Medullary thyroid carcinoma metastatic to breast masquerading as infiltrating lobular carcinoma. Annals of Clinical & Laboratory Science. 1994;24(5):441-7.

Lee AH. The histological diagnosis of metastases to the breast from extramammary malignancies. Journal of Clinical Pathology. 2007;60(12):1333-41.

Vizcaino I, Torregrosa A, Higueras V, Morote V, Cremades A, Torres V, Olmos S, Molins C. Metastasis to the breast from extramammary malignancies: A report of four cases and a review of literature. European Radiology. 2001;11 (9):1659-65.

Algeciras-Schimnich A, Preissner CM, Theobald JP, Finseth MS, Grebe SK. Procalcitonin: A marker for the diagnosis and follow-up of patients with medullary thyroid carcinoma. The Journal of Clinical Endocrinology & Metabolism. 2009;94(3): 861-8.

Tanwar P, Gandhi JS, Sharma A, Gupta M, Choudhary PS. Unusual metastasis of medullary thyroid carcinoma to the breast: A cytological and histopathological correlation. Journal of Cytology. 2018;35 (2):117.

Gardair C, Drabent P, Charveriat P, Bertheau P, Cahen-Doidy L. A misleading breast metastasis of medullary thyroid carcinoma. In Annales de Pathologie. 2019;39(1):9-13.

Wu LT, Averbuch SD, Ball DW, De Bustros A, Baylin SB, McGuire III WP. Treatment of advanced medullary thyroid carcinoma with a combination of cyclophosphamide, vincristine and dacarbazine. Cancer. 1994;73(2):432-6.

Trimboli P, Castellana M, Virili C, Giorgino F, Giovanella L. Efficacy of Vandetanib in treating locally advanced or metastatic medullary thyroid carcinoma according to RECIST criteria. A systematic review and meta-analysis. Frontiers in Endocrinology. 2018;9:224.

Sangoi AR, Shrestha B, Yang G, Mego O, Beck AH. The novel marker GATA3 is significantly more sensitive than traditional markers mammaglobin and GCDFP15 for identifying breast cancer in surgical and cytology specimens of metastatic and matched primary tumors. Applied Immunohistochemistry & Molecular Morphology: (AIMM). 2016;24 (4):229.