International Journal of Clinical Case Reports 2016, Vol.6, No.24, 1-7
5
The bone scintigraphy showed two foci uptake (sternal manubrium and the 11th posterior left rib).
Our patient was classified intermediate group (Heng classification, Table 1).
Table 1 : Heng classification
Criteria
Results
Indice of Karnofsky ECOG
0
Delay between the diagnosis and the treatment
Less than one year
Corrected calcium
Twice normal
Hemoglobin level
12,6 g/dl
Neutrophil count
65,2%
Platelets count
201000
On September 2014, the patient was operated; an enlarged right radical nephrectomy was performed. The
pathology study revealed a tubulo-papillary carcinoma of the right kidney, grade II of FUHRMAN (Gravitz tumor,
Figure 5).
Figure 5. Tubulo-papillary carcinoma of the right kidney, grade II of FUHRMAN
On February 2016, the patient underwent a targeted therapy (sunitinib: 50 mg for 4 weeks and followed by two
weeks without the treatment, eight cures).
The radiological evaluation after treatment found a regression of cervical, mediastinal and parietal lesions (with an
increase in necrosis areas) and a partial response of the pulmonary nodules with a good tolerance (Figure 6).
Figure 6. Neck mass reduction after 3 cures of targeted therapy (Sunitinib)
3 Discussion
The thyroid metastases are rare, a recent study showed that 1.9 to 22.4% of patients with generalized cancer, had
thyroid metastases after an evaluation at the autopsy (Mohammadi et al., 2014). The tumors that metastasize to the
