Pulmonary Small Cell Carcinoma with Thyroid and Cerebellum Metastases
-
Fariba Binesh
,
Najmeh Beheshti
,
Fatemeh Khaleghi Dehshiri
,
FatemeAlsadat Aghaei Meybodi
,
Maryam Vajihinejad
Abstract
Pulmonary small cell carcinoma typically metastasizes to lymph nodes, liver, adrenal glands, brain, and pleura; thyroid involvement is exceptionally rare. A 57-yearold woman presented with an eight-month history of progressive dyspnea. Clinical examination revealed an enlarged thyroid gland with palpable nodules in both lobes. Contrast-enhanced chest CT demonstrated a lobulated right hilar mass extending into the posterior mediastinum. CT-guided biopsy of the hilar lesion confirmed small cell lung carcinoma on histopathology. Fine needle aspiration of the thyroid nodules yielded hypercellular smears containing medium-sized round cells with hyperchromatic nuclei. To exclude primary medullary thyroid carcinoma with pulmonary metastasis,
serum calcitonin and carcinoembryonic antigen (CEA) were measured, revealing levels of 20 pg/mL and 49.91 ng/mL, respectively. Integrating these findings, the diagnosis of pulmonary small cell carcinoma with thyroid metastasis was established. This case underscores that, although rare, the thyroid gland can serve as a metastatic site for small cell lung carcinoma. Therefore, in patients with a known primary malignancy,
the appearance of a new thyroid nodule warrants prompt evaluation for possible metastatic disease.
[1] Smolarz B, Łukasiewicz H, Samulak D, Piekarska E, Kołaciński R, Romanowicz H. Lung Cancer-Epidemiology, Pathogenesis, Treatment and Molecular Aspect (Review of Literature). Int J Mol Sci. 2025 Feb 26;26(5):2049. https://doi.org/10.3390/ijms26052049
[2] Rudin CM, Brambilla E, Faivre-Finn C, Sage J. Small-cell lung cancer. Nat Rev Dis Primers. 2021 Jan 14;7(1):3. https://doi.org/10.1038/s41572-020-00235-0
[3] Li YD, Ye QY, Chen YX, Hu XR. Thyroid Cancer: Pathogenesis, Clinicopathology, Diagnosis, and Management. MedComm (2020). 2025 Oct 28;6(11):e70449. https://doi.org/10.1002/mco2.70449
[4] Orlandi AM, Alcaraz G, Bielski L, Brenta G, Jozami LC, Cavallo A, et al. Thyroid Department of Sociedad Argentina de
Endocrinología y Metabolismo. Thyroid gland: a rare site of metastasis. Endocrine. 2024 May;84(2):607-14. https://doi.
org/10.1007/s12020-023-03626-x
[5] Nixon IJ, Coca-Pelaz A, Kaleva AI, Triantafyllou A, Angelos P, Owen RP, et al. Metastasis to the Thyroid Gland: A Critical Review. Ann Surg Oncol. 2017 Jun;24(6):1533-9. https://doi. org/10.1245/s10434-016-5683-4
[6] Pusztaszeri M, Wang H, Cibas ES, Powers CN, Bongiovanni M, Ali S, et al. Fine-needle aspiration biopsy of secondary
neoplasms of the thyroid gland: a multi-institutional study of 62 cases. Cancer Cytopathol. 2015 Jan;123(1):19-29. https://doi.org/10.1002/cncy.21494
[7] AlSaedi AH, Almalki DS, ElKady RM. Approach to Thyroid Nodules: Diagnosis and Treatment. Cureus. 2024;16(1):e52232. https://doi.org/10.7759/cureus.52232
[8] Ghossein CA, Khimraj A, Dogan S, Xu B. Metastasis to the thyroid gland: a single-institution 16-year experience. Histopathology. 2021 Mar;78(4):508-19. https://doi.org/10.1111/his.14246
[9] Albany C, Jain A, Ulbright TM, Einhorn LH. Lung cancer, thyroid cancer or both: An unusual case presentation. J Thorac Dis. 2011 Dec;3(4):271-3. https://doi.org/10.3978/j.issn.2072-1439.2011.02.03
[10] Katsenos S, Archondakis S, Vaias M, Skoulikaris N. Thyroid gland metastasis from small cell lung cancer: an unusual
site of metastatic spread. J Thorac Dis. 2013 Apr;5(2):E21-4. https://doi.org/10.3978/j.issn.2072-1439.2012.06.03
[11] Xie S, Wu Z, Qi Y, Wu B, Zhu X. The metastasizing mechanisms of lung cancer: Recent advances and therapeutic challenges. Biomed Pharmacother. 2021 Jun;138:111450. https://doi.org/10.1016/j.biopha.2021.111450
[12] Milovanovic IS, Stjepanovic M, Mitrovic D. Distribution patterns of the metastases of the lung carcinoma in relation
to histological type of the primary tumor: An autopsy study. Ann Thorac Med. 2017 Jul-Sep;12(3):191-8. https://doi.
org/10.4103/atm.ATM_276_16
[13] Chung AY, Tran TB, Brumund KT, Weisman RA, Bouvet M. Metastases to the thyroid: a review of the literature from
the last decade. Thyroid. 2012 Mar;22(3):258-68. https://doi.org/10.1089/thy.2010.0154
[14] Tang Q, Wang Z. Metastases to the Thyroid Gland: What Can We Do? Cancers (Basel). 2022 Jun 19;14(12):3017. https://doi.org/10.3390/cancers14123017
[15] Falcone R, Ramundo V, Lamartina L, Ascoli V, Bosco D, Di Gioia C, et al. Sonographic Presentation of Metastases to the Thyroid Gland: A Case Series. J Endocr Soc. 2018 Jun 21;2(8):855-9. https://doi.org/10.1210/js.2018-00124
[16] Alhassan R, Al Busaidi N, Al Rawahi AH, Al Musalhi H, Al Muqbali A, Shanmugam P, et al. Features and diagnostic
accuracy of fine needle aspiration cytology of thyroid nodules: retrospective study from Oman. Ann Saudi Med.
2022 Jul-Aug;42(4):46-251. https://doi.org/10.5144/0256-4947.2022.246
[17] Song S, Kim H, Ahn SH. Role of Immunohistochemistry in Fine Needle Aspiration and Core Needle Biopsy of Thyroid Nodules. Clin Exp Otorhinolaryngol. 2019 May;12(2):224-30. https://doi.org/10.21053/ceo.2018.01011
[18] Kim KM, Ahn AR, Hong YT, Chung MJ. Primary small cell thyroid carcinoma combined with poorly differentiated thyroid carcinoma, evidence for a common origin: A case report. Oncol Lett. 2023 Apr 18;25(6):233. https://doi.org/10.3892/ol.2023.13819
[19] Gao X, Cao Z, Diao X, Zhang J, Zhao K, Yang L, et al. Clinicopathological features and outcomes of rare lung
adenocarcinoma metastasis to the thyroid gland: A single-center, 11-year experience. Thorac Cancer. 2025
Jan;16(1):e15486. https://doi.org/10.1111/1759-7714.15486
[20] Can AS, Köksal G. Thyroid metastasis from small cell lung carcinoma: a case report and review of the literature. J Med Case Rep. 2015 Oct 7;9:231. https://doi.org/10.1186/s13256- 015-0707-4
[21] Osawa M, Takigawa N, Kiura K, Ichimura K, Matsuoka J, Hotta K, et al. Isolated metastasis of lung cancer to the thyroid gland. Lung Cancer. 2007 Oct;58(1):156-8. https://doi.org/10.1016/j.lungcan.2007.04.014
[2] Rudin CM, Brambilla E, Faivre-Finn C, Sage J. Small-cell lung cancer. Nat Rev Dis Primers. 2021 Jan 14;7(1):3. https://doi.org/10.1038/s41572-020-00235-0
[3] Li YD, Ye QY, Chen YX, Hu XR. Thyroid Cancer: Pathogenesis, Clinicopathology, Diagnosis, and Management. MedComm (2020). 2025 Oct 28;6(11):e70449. https://doi.org/10.1002/mco2.70449
[4] Orlandi AM, Alcaraz G, Bielski L, Brenta G, Jozami LC, Cavallo A, et al. Thyroid Department of Sociedad Argentina de
Endocrinología y Metabolismo. Thyroid gland: a rare site of metastasis. Endocrine. 2024 May;84(2):607-14. https://doi.
org/10.1007/s12020-023-03626-x
[5] Nixon IJ, Coca-Pelaz A, Kaleva AI, Triantafyllou A, Angelos P, Owen RP, et al. Metastasis to the Thyroid Gland: A Critical Review. Ann Surg Oncol. 2017 Jun;24(6):1533-9. https://doi. org/10.1245/s10434-016-5683-4
[6] Pusztaszeri M, Wang H, Cibas ES, Powers CN, Bongiovanni M, Ali S, et al. Fine-needle aspiration biopsy of secondary
neoplasms of the thyroid gland: a multi-institutional study of 62 cases. Cancer Cytopathol. 2015 Jan;123(1):19-29. https://doi.org/10.1002/cncy.21494
[7] AlSaedi AH, Almalki DS, ElKady RM. Approach to Thyroid Nodules: Diagnosis and Treatment. Cureus. 2024;16(1):e52232. https://doi.org/10.7759/cureus.52232
[8] Ghossein CA, Khimraj A, Dogan S, Xu B. Metastasis to the thyroid gland: a single-institution 16-year experience. Histopathology. 2021 Mar;78(4):508-19. https://doi.org/10.1111/his.14246
[9] Albany C, Jain A, Ulbright TM, Einhorn LH. Lung cancer, thyroid cancer or both: An unusual case presentation. J Thorac Dis. 2011 Dec;3(4):271-3. https://doi.org/10.3978/j.issn.2072-1439.2011.02.03
[10] Katsenos S, Archondakis S, Vaias M, Skoulikaris N. Thyroid gland metastasis from small cell lung cancer: an unusual
site of metastatic spread. J Thorac Dis. 2013 Apr;5(2):E21-4. https://doi.org/10.3978/j.issn.2072-1439.2012.06.03
[11] Xie S, Wu Z, Qi Y, Wu B, Zhu X. The metastasizing mechanisms of lung cancer: Recent advances and therapeutic challenges. Biomed Pharmacother. 2021 Jun;138:111450. https://doi.org/10.1016/j.biopha.2021.111450
[12] Milovanovic IS, Stjepanovic M, Mitrovic D. Distribution patterns of the metastases of the lung carcinoma in relation
to histological type of the primary tumor: An autopsy study. Ann Thorac Med. 2017 Jul-Sep;12(3):191-8. https://doi.
org/10.4103/atm.ATM_276_16
[13] Chung AY, Tran TB, Brumund KT, Weisman RA, Bouvet M. Metastases to the thyroid: a review of the literature from
the last decade. Thyroid. 2012 Mar;22(3):258-68. https://doi.org/10.1089/thy.2010.0154
[14] Tang Q, Wang Z. Metastases to the Thyroid Gland: What Can We Do? Cancers (Basel). 2022 Jun 19;14(12):3017. https://doi.org/10.3390/cancers14123017
[15] Falcone R, Ramundo V, Lamartina L, Ascoli V, Bosco D, Di Gioia C, et al. Sonographic Presentation of Metastases to the Thyroid Gland: A Case Series. J Endocr Soc. 2018 Jun 21;2(8):855-9. https://doi.org/10.1210/js.2018-00124
[16] Alhassan R, Al Busaidi N, Al Rawahi AH, Al Musalhi H, Al Muqbali A, Shanmugam P, et al. Features and diagnostic
accuracy of fine needle aspiration cytology of thyroid nodules: retrospective study from Oman. Ann Saudi Med.
2022 Jul-Aug;42(4):46-251. https://doi.org/10.5144/0256-4947.2022.246
[17] Song S, Kim H, Ahn SH. Role of Immunohistochemistry in Fine Needle Aspiration and Core Needle Biopsy of Thyroid Nodules. Clin Exp Otorhinolaryngol. 2019 May;12(2):224-30. https://doi.org/10.21053/ceo.2018.01011
[18] Kim KM, Ahn AR, Hong YT, Chung MJ. Primary small cell thyroid carcinoma combined with poorly differentiated thyroid carcinoma, evidence for a common origin: A case report. Oncol Lett. 2023 Apr 18;25(6):233. https://doi.org/10.3892/ol.2023.13819
[19] Gao X, Cao Z, Diao X, Zhang J, Zhao K, Yang L, et al. Clinicopathological features and outcomes of rare lung
adenocarcinoma metastasis to the thyroid gland: A single-center, 11-year experience. Thorac Cancer. 2025
Jan;16(1):e15486. https://doi.org/10.1111/1759-7714.15486
[20] Can AS, Köksal G. Thyroid metastasis from small cell lung carcinoma: a case report and review of the literature. J Med Case Rep. 2015 Oct 7;9:231. https://doi.org/10.1186/s13256- 015-0707-4
[21] Osawa M, Takigawa N, Kiura K, Ichimura K, Matsuoka J, Hotta K, et al. Isolated metastasis of lung cancer to the thyroid gland. Lung Cancer. 2007 Oct;58(1):156-8. https://doi.org/10.1016/j.lungcan.2007.04.014
| Files | ||
| Issue | Vol 10 No 6 (2025): November- December | |
| Section | Case Report(s) | |
| Keywords | ||
| Small cell lung carcinoma Thyroid metastasis Fine needle aspiration | ||
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How to Cite
1.
Binesh F, Beheshti N, Khaleghi Dehshiri F, Aghaei Meybodi F, Vajihinejad M. Pulmonary Small Cell Carcinoma with Thyroid and Cerebellum Metastases. CRCP. 2026;10(6):260-264.
