Thyroid metastasis as the first manifestation of lung cancer.

A 66-year-old man presented with a thyroid nodule and enlargement of neighboring lymph nodes. The patient was admitted because of a decline in general health with dysphagia. Investigations of the gastrointestinal tract was normal. Serum thyroglobulin levels were moderately elevated. A biopsy of the upper lobe of the left lung demonstrated an undifferentiated carcinoma, and a Tru-cut biopsy of the thyroid mass was consistent with a metastasis from the bronchial lesion. Thyroid metastases are rare, often small (<1 cm), and generally asymptomatic. Their diagnosis usually requires a surgical or Tru-cut biopsy. The prognosis is poor, although prolonged survivals have been reported after surgical removal of thyroid metastases in some types of cancer.