Anaplastic thyroid carcinoma presenting with gastric metastasis: a case report

Anaplastic thyroid carcinoma (ATC) has the most aggressive progression among thyroid malignancies. Most of the patients have metastasis, especially to the lungs, liver and regional lymph nodes, at the time of diagnosis. Gastrointestinal tract metastasis of ATC has been rarely reported. We report a case who presented with gastrointestinal bleeding and was diagnosed with ATC accompanied with gastric, skin, lung and adrenal gland metastases.

A 72-year-old male patient presented with one month history of neck mass, weight loss and weakness and three-day-history of melena. On examination his thyroid gland was tender on palpation and hyperplasic, multiple, painful, solid, and fixed nodules were palpated.Ultrasonographic neck examination demonstrated an enlarged thyroid gland and multiple hypoechoic nodules including cystic degenerative areas; the largest 28 x 23 mm in size. Thyroid fine needle aspiration biopsy was performed and biopsy results indicated ATC. Gastroscopy, performed due to the gastrointestinal bleeding, detected a 4 x 6 mm polypoid lesion on sternal pili of the gastric cardia and histopathological examination of its biopsy demonstrated metastasis of ATC.

We reported a case of ATC with gastric, skin, lung and adrenal gland metastases, initially presenting with gastrointestinal bleeding due to the gastric metastasis. Hippokratia 2015, 19 (1): 85-87.