ABSTRACT
INTRODUCTION: An exponential increase in thyroid cancer has been reported in Mexico with 12,122 new cases in 2018 it represents the most common endocrinological cancer described by the World Health Organization. Attributing it local and distant metastatic lesions, being unusual the orbital condition. CLINICAL CASE: A 56-year-old woman diagnosed with chronic myeloid leukemia 19 years ago, presented with left eye proptosis and tearing, headaches, worsening left facial neuralgia. CONCLUSIONS: In these cases, the surgical treatment is essential to improve patient's symptoms and quality of life.
INTRODUCCIÓN: En México existe un aumento exponencial del cáncer de tiroides, con 12,122 nuevos casos en 2018, representando el cáncer endocrinológico más frecuente descrito por la Organización Mundial de la Salud. Se le atribuyen lesiones metastásicas locales y a distancia, siendo una presentación inusual la afección orbitaria. CASO CLÍNICO: Mujer de 56 años diagnosticada de leucemia mieloide crónica hace 19 años, que acude por cefalea, proptosis e hiperemia conjuntival con limitación a la abducción, y dolor facial izquierdo. CONCLUSIONES: En estos casos, el tratamiento quirúrgico es indispensable para mejorar la sintomatología y la calidad de vida del paciente.
Subject(s)
Orbital Neoplasms , Thyroid Neoplasms , Female , Humans , Mexico , Middle Aged , Quality of Life , Thyroid Neoplasms/surgeryABSTRACT
Capillary thyroid carcinoma (PTC) is the most common neoplasm of thyroid. It usually grows slowly and is clinically indolent, although rare, its aggressive forms with local invasion or distant metastases can occur. Metastatic thyroid carcinoma rarely involves the orbit. We reported an uncommon case of orbital metastasis of PTC. A 66-years-old woman presented proptosis of the right eye. The biopsy of the tumor in orbit revealed metastatic thyroid carcinoma. The ultrasensitive TSH level was 1,34 mUI/L and free T4 level was 1,65 ng/dL. A total thyroidectomy was performed and histopathological analysis of the nodule revealed follicular variant of papillary thyroid carcinoma. Currently, the patient has been receiving palliative chemotherapy with Clodronate Disodium. The importance of the case is due to its unusual presentation, which emerged as a primary clinical manifestation. Although rare, thyroid carcinoma should be suspected in orbit metastasis.
Carcinoma papilífero da tiróide (PTC) é a neoplasia mais comum da tiróide. Geralmente cresce lentamente e é clinicamente indolente, embora raras, as formas agressivas com invasão local ou metástases distantes podem ocorrer. Carcinoma metastático da tiróide raramente envolve a órbita. Relatamos um caso raro de metástase orbital de PTC. Uma mulher de 66 anos apresentou proptose no olho direito. A biópsia do tumor em órbita revelou carcinoma metastático da tiróide. O nível ultra-sensível do TSH foi de 1,34 mUI/L e T4 livre foi de 1,65 ng/dL. A tireoidectomia total foi realizada e a análise histopatológica do nódulo revelou carcinoma papilífero variante folicular da tiróide. Atualmente, a paciente recebe quimioterapia paliativa com clodronato dissódico. A importância do caso é devido à sua apresentação incomum que surgiu como principal manifestação clínica. Embora raro, o carcinoma da tiróide deve ser pensado em metástase orbitária.