Metastatic cervical carcinoma with ectopic calcitonin production presenting as a thyroid mass.

ABSTRACT

OBJECTIVE: To describe a case of cervical carcinoma metastatic to the thyroid in association with ectopic production of calcitonin. METHODS: We present the medical history, clinical findings, and laboratory results in a 38-year-old woman with a neck mass, and we discuss the frequency of metastatic involvement of the thyroid. RESULTS: A 38-year-old woman was referred for evaluation of an enlarging neck mass. She had undergone radical hysterectomy and irradiation for invasive cervical carcinoma 1 year earlier. Laboratory investigation showed only mild anemia, high plasma bicarbonate concentration, increased alkaline phosphatase, and mild hypoalbuminemia. Computed tomography of the abdomen and pelvis disclosed multiple lesions in the liver. Fine-needle aspiration biopsy of the thyroid mass revealed a poorly differentiated carcinoma, which stained negative for thyroglobulin but positive for several neuroendocrine tumor markers. Measurement of serum calcitonin showed a dramatically increased level (5,000 pg/mL). The same histologic and immunochemical profile was found in a liver biopsy specimen and in the original cervical tumor. Metastatic neuroendocrine cervical carcinoma was diagnosed, and the patient died 6 months later despite four cycles of chemotherapy. CONCLUSION: To the best of our knowledge, this is the first case report of a neuroendocrine cervical carcinoma manifesting as a palpable thyroid mass, associated with ectopic production of calcitonin.