Synchronous papillary thyroid carcinoma and breast ductal carcinoma in 37 years old Iranian woman - A case report

Background: Breast carcinoma and thyroid carcinoma are the 2 most common malignancies that occur in women. synchronous neoplasms of both thyroid and breast cancer are very rare in clinic. There appears to be an increased risk of breast cancer in women with thyroid cancer. It is proposed that the mechanism of these synchronous primary tumors is associated with an interaction between the breast and thyroid hormonal responses. Wang et al, reported that RET/PTC kinase is not only a proto-oncogene highly expressed in papillary thyroid carcinoma but also is involved in breast cancer growth, prognosis and resistance to Tamoxifen, so it seems to be a relation between these two cancers in oncogenesis.Case summary: The current study presents a case of synchronous papillary thyroid carcinoma and breast ductal carcinoma in 37 years old woman. The patient was healthy prior to diagnosis and just had family history of thyroid cancer in her mother. First Symptoms was asymmetrically enlarged right breast after lactation period and feeling a mass in the right neck four months before diagnosis. After ultrasound sonography of thyroid and cervical region, she underwent right thyroid FNA with pathology diagnosis of suspicious thyroid nodule (Bethesda category V). In the following sonography and mammography of right breast showed an irregular border mass in upper outer quadrants of right breast (BIRADS 4s). After right breast mass core needle biopsy and post-operative pathology diagnosis of Invasive ductal carcinoma; the patient underwent a lumpectomy procedure and sentinel axillary lymph node intra-operative frozen study of right breast and also total thyroidectomy and right lymph node resection (zone II to V) simultaneously at Sina hospital, Tehran. Post-operative pathological examination of all samples identified invasive ductal carcinoma of the right breast (grade II/III) with free sentinel lymph node and papillary carcinoma of the thyroid (Classic and follicular variant, PT2) with cervical lymph nodes metastasis by both breast and thyroid cancers. 8 out of 11 lymph nodes were involved by breast carcinoma and one lymph node was involved by thyroid carcinoma. Conclusion: Although synchronous primary tumors of the thyroid and breast are very rare, they remain a possibility; therefore, more attention should be paid to these cases. In this case although axillary sentinel lymph node was free from tumor, cervical lymph nodes were involved by breast carcinoma; showing importance of cervical examination in breast cancer patients.

کلیدواژه ها:

breast ، case report ، ductal carcinoma ، papillary ، thyroid carcinoma