Scalp metastasis as an initial presentation of lung adenocarcinoma : A case report and literature review

IntroductionCutaneous metastasis from primary visceral malignancy is a relatively uncommon clinical entity, with a reported incidence of 0.22%–10% among various series. However, the presence of cutaneous metastasis as the first sign of a clinically silent visceral cancer is exceedingly rare.Presentation of caseWe describe here a case of an asymptomatic male patient who presented with a solitary scalp metastasis as the initial manifestation of an underlying lung cancer. Diagnostic evaluation revealed advanced disease.DiscussionThe report emphasizes that physicians should be aware of this rare clinical entity, and appropriate investigation should be arranged for early diagnosis and initiation of the appropriate treatment. The occurrence of skin lesions in lung cancer announces an ominous prognosis.ConclusionWe conclude that the possibility of metastatic skin disease should always be considered in the differential diagnosis in patients with a history of smoking or lung cancer presenting with cutaneous nodules.     

A case of duodenal intramural metastasis from gastric cancer

INTRODUCTIONHere, we report a case of duodenal intramural metastasis from gastric cancer, which is extremely rare.PRESENTATION OF CASEA 72-year-old man was admitted to our hospital with a chief complaint of lack of appetite in 2010. An endoscopic evaluation detected a Borrmann type 2 tumor occupying the lesser curvature of the gastric body and antrum, and pyloric stenosis. The patient underwent total gastrectomy. In an examination of the resected specimen, a type 2 tumor was identified in the middle gastric body and antrum, and a submucosal tumor was detected in the duodenal bulb. A histopathological examination demonstrated that the gastric tumor was not contiguous with the duodenal submucosal tumor. A microscopic examination demonstrated that the gastric tumor was a moderately to poorly differentiated adenocarcinoma and displayed lymphatic permeation. The duodenal submucosal tumor was also found to be an adenocarcinoma and was similar to the gastric tumor; therefore, we diagnosed the duodenal tumor as an intramural metastasis from gastric cancer.DISCUSSIONThe most common route of metastasis from gastric cancer involves hematogenous metastasis, lymph node metastasis, and peritoneal metastasis. Intramural metastasis from gastric cancer is rare and has been reported to be a variant of lymphogenic metastasis. The clinicopathological features of patients with duodenal intramural metastasis from gastric cancer are unclear because only one case of the condition has been reported.CONCLUSIONDuodenal intramural metastasis from gastric cancer is an advanced form of cancer, and we suggest that it should be treated with surgical resection followed by adjuvant therapy.     

Palmar metastasis of an adenocarcinoma of the esophago-gastric-junction: First case report

INTRODUCTIONHand metastasis represents only approximately 0.007–0.2% of all metastatic lesions. The most common origin of hand metastasis is the lung, which is approximately 50% of all cases, followed by breast and kidney. Hand metastasis from gastric or esophagic cancer is even much more rare.PRESENTATION OF CASEThis is the first case report of a metastasis to the palm of hand (tendon) due to an adenocarcinoma of esophago-gastric-junction.DISCUSSIONWhile most of the esophagic and gastric carcinomas metastasizes to liver, lungs and brain, the rare possibility of encountering metastasis to the hand either to the bone, but also to the tendon exists. Therefore, we recommend obtaining a thorough history and a detailed clinical examination, plain radiographs, followed by axial imaging techniques like MRI and a histopathologic evaluation.CONCLUSIONEven if metastatic lesions to the hand are really rare, the surgeon should always be suspicious of a metastatic lesion, when presented with a patient older than 40 years who has a history of cancer.     

Long-term survival of a patient with advanced gastric cancer with paraaortic lymph node metastasis who attained pathological complete response after S-1/CDDP chemotherapy: A case report

IntroductionGastric cancer with paraaortic lymph node (PAN) metastasis have unfavorable prognosis. There are no evidence-based preoperative chemotherapy regimens available.Case presentationA 62-year-old female was diagnosed with advanced gastric cancer and PAN metastasis. We attempted S-1/CDDP chemotherapy in six coursed and total gastrectomy as well as systematic dissection of regional lymph nodes and PAN. Histologically, no cancerous cells were detected in specimens. The patient has been disease-free for 5 years since the surgery.DiscussionLong-term survival case of gastric cancer with PAN metastasis attaining pathologically complete response is extremely rare. It is possible that preoperative S1/CDDP with surgery might be a standard treatment strategy for gastric cancer with PANs.ConclusionWe report herein a rare case of gastric cancer with PAN metastases who achieved a 5-year survival after S-1/CDDP chemotherapy and surgery.     

Acute acalculous cholecystitis caused by gallbladder metastasis due to the peritoneal dissemination of gastric cancer: A case report

Introduction and importanceAcute acalculous cholecystitis (AAC) is associated with a high mortality rate. AAC caused by metastasis to the gallbladder is rare. We report a case of AAC caused by gallbladder metastasis due to the peritoneal dissemination of gastric cancer.Case presentationAn 84-year-old male visited our hospital because of epigastric pain. Ultrasonography and computed tomography revealed swelling and thickening of the gallbladder wall, but stones were not observed in the gallbladder. We performed emergency surgery with a diagnosis of acute cholecystitis. Laparoscopy revealed the presence of many nodules around the abdominal cavity including the hepatoduodenal ligament. Inflammation of Calot’s triangle was severe, so we performed subtotal cholecystectomy. We also resected one of the peritoneal nodules. Macroscopically, there were no stones in the gallbladder and histopathological examination revealed acute cholecystitis and existence of adenocarcinoma involving the subserosa of the gallbladder wall and the resected peritoneal nodule. After surgery, esophagogastroduodenoscopy revealed Borrmann type II lesions at the antrum and gastric biopsy showed adenocarcinoma. He was diagnosed with advanced gastric cancer with peritoneal dissemination. His postoperative course was good.Clinical discussionThe cases of AAC caused by gallbladder metastasis have been little reported in the literature. This case is advanced gastric cancer with peritoneal dissemination and AAC was thought to be caused by peritoneal dissemination from operative and histopathological findings. We successfully treated this rare case of AAC with laparoscopic surgery.ConclusionAlthough metastasis to the gallbladder is rare, it is necessary to be aware of this possibility when treating AAC.     

A case of gastric cancer metastasis to the breast in a female with BRCA2 germline mutation and literature review

Introduction: Gastric cancer is a deadly disease. Common sites of distant metastasis of gastric cancer are the peritoneum, liver, lymph nodes, and lung. The breast is a rare site of metastasis in gastric cancer which occurs in males dominantly.

Patients and methods: Here, we report the first case of metastatic gastric cancer to the breast in a patient with the breast cancer 2 (BRCA2) germline mutation. A 34-year-old female was admitted to the hospital with dyspepsia and a palpable mass in the left breast. Gastric cancer was confirmed to be signet ring cell adenocarcinoma. The breast mass exhibited histological properties consistent with gastric cancer. Immunohistochemistry results showed the breast tumor was CDX-2 and CK20-positive, but ER-, CK7-, and GATA3-negative. The BRCA1 gene had a wild-type sequence, but a heterozygous variant was discovered in BRCA2 in exon 10 (c.1744A?>?C, p.T582P); the significance of this variant is unknown.

Results: The patient received palliative XELOX (capecitabine?+?oxaliplatin) with radiation therapy to the stomach. The breast tumor resolved completely, but the overall response was partial.

Conclusion: Gastric cancer metastasis to the breast is rare, but should be considered in young female patients with signet ring cell type gastric cancer.     

A case report of testicular diffuse large B-cell malignant lymphoma with cutaneous metastasis: A rare entity

Introduction and importancePrimary testicular lymphoma (PTL) is a variety of extra-nodal lymphoma taking origin from testis. It accounts 5% of all testicular tumors. Metastasis may occur in contralateral testis, bone, central nervous system and rarely in skin. Herein, we present the case of testicular diffuse large B-cell malignant lymphoma with cutaneous metastasis.Case presentationA 60-year-old male presented with swollen painless solid right testis, with homolateral inguinal nodes. Testicular tumors markers were within normal range. Right radical orchidectomy was performed. Histopathological examination concluded to the diagnosis of Diffuse Large B Cell Lymphoma. Four weeks later, the patient presented alteration of general condition and multiples cutaneous centimetric lesions located in the right inguinal region. Biopsy of this lesion confirmed the diagnosis of metastases from the testicular lymphoma. The patient deceased three days later, before starting further treatment.Clinical discussionPrimary testicular lymphoma is a rare variety of testicular tumors. The prognosis is poor. Metastasis may occur in different sites such as contralateral testis, central nervous system, and skin. The prognosis is usually poor in the rare case of cutaneous metastasis.ConclusionPrimary testicular tumor is an aggressive rare variety of testicular tumors with poor prognosis. Cutaneous metastasis is rarely reported. Cutaneous lesions should be explored and suspected to be malignant. Early treatment with rapid multidisciplinary management is the key for adequate approach.     

Angiogenesis as an unfavorable factor related to lymph node metastasis in early gastric cancer

Background: Recent studies suggest that angiogenesis enhances tumor growth and metastasis. Lymph node metastasis influences the prognosis and selection of treatment modalities in cancers. In this study, the authors investigated the correlation between angiogenesis and clinicopathologic features to determine whether angiogenesis correlated with lymph node metastasis in early-stage gastric cancer. Methods: A total of 97 specimens from patients with early gastric cancer were studied by immunohistochemical methods using anti-Factor VIII-related antigen antibody. Results: Tumor size was significantly correlated with microvessel count, which increased as tumor size increased. Microvessel counts from tumors with lymphatic vessel invasion, lymph node metastasis, and submucosal invasion were significantly higher than those without. Furthermore, microvessel count was an independent factor that influenced lymph node metastasis (P=.0016) by multivariate logistic regression analysis. Conclusion: In the early stage of gastric carcinoma, angiogenesis is an independent factor that impacts on lymph node metastasis.     

Carcinomatous Lymphatic Invasion in Early Gastric Cancer Invading Into the Submucosa

Background: Lymphatic invasion is a risk factor for lymph node metastases in patients with gastric cancer. No studies have been reported, however, on the correlation between lymphatic invasion and lymph node metastasis in early gastric cancer invading into the submucosa.Methods: We performed a retrospective analysis of lymphatic invasion in 170 patients with early gastric cancer invading into the submucosa.Results: Lymphatic invasion was found in 76 patients. Lymphatic invasion correlated significantly with the presence of lymph node metastasis and vascular invasion (P < .05) and with the degree of cancerous submucosal involvement (P < .05). The presence of lymph node metastasis also correlated with the grade of submucosal invasion and lymphatic invasion. The 5-year survival of patients with lymphatic invasion was poorer than that of patients without lymphatic invasion (P < .05). Node-negative patients had similar survival, regardless of the presence of lymphatic invasion. All patients with severe lymphatic invasion had sm3 invasion and lymph node metastases.Conclusion: Although lymphatic invasion is the first stage of lymph node metastasis, lymphatic invasion in itself does not have clinical importance except for severe invasion in early gastric cancer. It is possible to predict lymph node metastases from the combined evaluation of degree of lymphatic invasion and submucosal involvement of the tumor in patients with early gastric cancer invading into the submucosa.     

Gastric perforation secondary to metastasis from ovarian cancer: Case report

INTRODUCTIONMetastasis from ovarian cancer occurs frequently through the peritoneal cavity in the form of peritoneal carcinomatosis; isolated gastric metastasis is rarely reported in literature.PRESENTATION OF CASEWe present a case of 43-year-old infertile lady, who developed a picture of acute abdomen four days post total abdominal hysterectomy and salpingoopherectomy for ovarian cancer. Further contrast-enhanced CT scan demonstrated massive free gas and fluid in the abdomen. She underwent antrectomy with truncal vagotomy due to 3 cm × 4 cm prepyloric gastric ulcer. Final pathology proved the presence of metastatic serous cystadenocarcinoma of ovarian origin.DISCUSSIONOur patient had a gastric perforation secondary to ovarian metastasis. Being isolated, the absence of ascites and the transmural nature of the gastric metastasis suggest haematogenous spread .To the best of our knowledge perforated gastric metastasis secondary to ovarian cancer was not reported in literature before.CONCLUSIONGastric metastasis should be kept in mind in patients with a well-known ovarian cancer who present with gastric lesions, ulcers, bleeding or perforation.     

Lymph node metastasis as a significant prognostic factor in early gastric cancer: Analysis of 1,136 early gastric cancers

Background: Gastric cancer is the most frquent cancer and the leading cause of death from cancer in Korea. Early gastric cancer has been defined as a gastric carcinoma confined to mucosa or submucosa, regardless of lymph node status, and has an excellent prognosis with a >90% 5-year survival rate. From 1974 to 1992, we encountered 7,606 cases of gastric cancer and performed 6,928 gastric resections. Among them, 1,136 cases were early gastric cancer (14.9% of all gastric cancer cases and 16.4% of resected gastric cancer cases). Methods: A retrospective analysis of 1,136 cases of early gastric cancer was performed to evaluate the prognostic significance of clinicopathologic features (sex, age, tumor location, gross type, histologic type, depth of invasion, status of lymph node metastasis, resection type). Lymph node metastasis was classified into three groups: N(n=0) for no lymph node metastasis; N(n=1–3) for one to three lymph node metastases; and N(n>3) for more than three lymph node metastases. All patients received radical total or subtotal gastrectomy with lymph node dissection. Results: In univariate and multivariate analysis of these nine factors, the only statistically significant prognostic factor was regional lymph node metastasis (p<0.001). The others had no statistically significant association with prognosis. Lymph node metastasis was present in 178 cases (15.7%). The factors associated with the lymph node metastasis were depth of invasion and gross type [protruding type (e.g., types I, IIa)]. One hundred twenty-five of these patients had one to three lymph node metastases, and 53 cases had more than three lymph node metastases. The difference in 5-year survival rates among these groups was statistically significant: 94.5% for N(n=0), 88.3% for N(n=1–3), and 77.3% for N(n>3). Conclusion: We propose that for early gastric cancer, lymph node dissection is necessary in addition to gastric resection, at least in patients with a high risk of lymph node metastasis.     

NNK Enhances Cell Migration through α7-nicotinic Acetylcholine Receptor Accompanied by Increased of Fibronectin Expression in Gastric Cancer

Background

In this study, we intended to dissect the mechanism of 4-(Methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK)-enhanced migration of gastric cancer. Smoking has been defined as a risk factor for gastric cancer. Tobacco-specific carcinogen, NNK, was reported to enhance cancer progression in gastric cancer. Currently, metastasis is the major issue for clinical cancer therapy, but the influence of NNK on the migration of gastric cancer remains to be determined.

Methods

The expression of nicotinic receptor in gastric cancer cells was identified by real-time polymerase chain reaction and Western blotting. The influence of NNK on migration of gastric cancer cells was evaluated by the transwell migration assay system. Receptor-mediated migration was studied by both inhibitor and small interfering RNA.

Results

Alpha7 nicotinic acetylcholine receptor, alpha7-nicotinic acetylcholine receptor (nAChR), was identified higher than alpha9-nAChR in gastric cancer cell lines, AGS cells. NNK enhanced significantly gastric cancer cell migration in transwell assay. We used inhibitor and siRNA to demonstrate that alpha7-nAChR mediated NNK-enhanced gastric cancer cell migration and upregulation of fibronectin were involved in NNK-enhanced migration of gastric cancer cells. Finally, we found that silenced fibronectin expression level inhibited the migratory ability in AGS cells.

Conclusions

NNK enhanced gastric cancer metastasis through alpha7-nAChR and fibronectin—one of the hallmarks of epithelial mesenchymal transition.

     

Impact of Splenectomy for Lymph Node Dissection on Long-Term Surgical Outcome in Gastric Cancer

Background:In the treatment of gastric cancer, splenectomy is performed for effective lymph node dissection around the splenic artery and splenic hilum. The purpose of this study was to clarify the long-term outcome of splenectomy in the treatment of gastric cancer.Methods: The effect of splenectomy on recurrence and prognosis was examined in a retrospective analysis of 665 patients who had undergone curative total gastrectomy for gastric carcinoma from 1987 to 1996. The risk factors associated with recurrence and prognosis were investigated by univariate and multivariate analysis.Results: The splenectomy group showed more advanced lesions and a higher recurrence rate than the spleen-preserved group. However, after adjusting for the TNM (tumor, node, metastasis) stage, there was no significant difference in recurrence rate and pattern between the two groups. Logistic regression analysis revealed that gross type, serosal invasion, and nodal metastasis were independent risk factors for recurrence while splenectomy was not. When comparing patients with the same TNM (tumor, node, metastasis) stages, no significant difference in the 5-year survival rates was apparent. Multivariate analysis demonstrated that age, serosal invasion, and nodal metastasis were independent prognostic factors whereas splenectomy was not.Conclusions: These data suggest that splenectomy for lymph node dissection in gastric cancer is not effective regarding long-term patient prognosis.     

Metastatic renal cell carcinoma presenting as gastric polyps: A case report and review of the literature

INTRODUCTIONRenal cell carcinoma (RCC) accounts for approximately 3% of adult malignancies and is responsible for over 13,000 deaths in the U.S. annually. The fatalities are largely due to distant metastasis, with lung, liver, bone and brain being most commonly affected organs. Gastric metastasis from RCC is a rare event (less than 20 cases reported in the English language literature) and usually presents as a large, solitary mass or ulcer (average size of 4.8 cm) resembling primary gastric cancer. Here we report the first case of metastatic RCC presenting as small gastric polyps.PRESENTATION OF CASEThe patient was a 60-year-old African American woman with a history of clear cell RCC (pT1bNX). She underwent esophagogastroduodenoscopy and colonoscopy 5 months after nephrectomy due to anemia. Two non-ulcerated, 0.6-cm benign-appearing polyps were found at the greater curvature of the gastric body, which were subsequently removed endoscopically. Unexpectedly, histopathologic examination of the gastric polyps revealed nested collections of vacuolated epithelioid cells in a background of delicate, arborizing vasculature, immediately beneath the congested and hyperplastic foveolar epithelium. A diagnosis of metastatic RCC was rendered after confirming the renal epithelial origin by immunohistochemical stains.DISCUSSIONGastric metastasis from RCC usually presents as a large, solitary mass or ulcer, but it can be subtle and present as multiple, small benign-appearing polyps.CONCLUSIONA careful follow up and thorough endoscopic and histopathologic examinations should be conducted in patients with a history of RCC who present with gastrointestinal manifestations.     

MiRNA-199a-3p in Plasma as a Potential Diagnostic Biomarker for Gastric Cancer

Background

MicroRNA (miRNA) has been shown the potential of cancer diagnosis. We investigated whether plasma miRNA expression could discriminate between patients with and without gastric cancer.

Methods

This study was divided into three steps: (1) miRNA microarray profiling on plasma samples from 20 gastric cancer patients and 20 healthy controls; (2) miRNA selection by real-time qRT-PCR on 30 pairs of plasma from patients and controls; and (3) qRT-PCR validation on an independent set of plasma from 180 gastric cancer patients, 80 healthy controls, and 20 patients with gastric precancerous diseases.

Results

Of the 959 human miRNAs analyzed by microarray, 37 up-regulated miRNAs and seven down-regulated miRNAs were found in gastric cancer plasma. Of the seven discrepant miRNAs validated on the plasma from 30 gastric cancer patients and 30 healthy controls, both miRNA-199a-3p and miRNA-151-5p were significantly elevated (p < 0.05) and were significantly reduced after surgery (p < 0.05) in gastric cancer patients. Further large-scale validation showed that these two miRNAs expressions in plasma were significantly higher in gastric cancer patients than healthy controls and patients with gastric precancerous diseases, respectively. However, only the expression of miRNA-199a-3p in plasma was significantly associated with tumor invasion and with lymph node metastasis and tumor, node, metastasis stage. This marker yielded an area under the receiver operating characteristic curve area of 0.837 with 80 % sensitivity and 74 % specificity in discriminating gastric cancer patients from healthy controls. In gastric cancer tissue, miRNA-199a-3p was expressed in the cytoplasm of tumor cells.

Conclusions

miRNA-199a-3p in plasma could be a novel potential diagnostic biomarker for gastric cancer detection.

     

Clinicopathologic significance of Her-2 and P53 expressions in gastric cancer

BackgroundTo detect the expression of HER-2 and P53 patients with gastric cancer and to analyze their correlation.MethodsA total of 249 gastric cancer patients with complete clinical data who received surgical treatment from China–Japan Union Hospital of Jilin University were selected. The expression of Her-2 and P53 were detected by immunohistochemistry using the streptavidin-biotin-peroxidase method. The correlations between HER-2 and P53 in gastric cancer were analyzed.ResultsThe positive rate of Her-2 and P53 expression was 37.3% (93/249) and 100% in all the specimens, respectively. The intensity of Her-2 expression was significantly different in patients with different degrees of gastric cancer cell differentiation (P = 0.012). Meanwhile, the expression of her-2 was closely related to whether the pathological type of gastric cancer was a signet-ring cell carcinoma (P = 0.022). Different percentage of positive P53 expression was closely related to the grade of tumor differentiation (P = 0.035) and positive Ki67 expression (P = 0.001). There was a significant positive correlation between HER-2 and P53 expression in gastric cancer (P = 0.003). These findings suggest that HER-2 and P53 have synergistic effects in gastric cancer.ConclusionHer-2 and P53 are important markers for invasion and metastasis of gastric cancer. Combined detection of P53 and Her-2 expression in gastric cancer tissue can be used to assess prognosis and screen cancer patients at high risk of metastasis.     

The expression of long non-coding RNA LINC01279 in gastric adenocarcinoma and its clinical significance

ObjectiveTo investigate the expression of long non-coding RNA LINC01279 in gastric cancer and its relationship with the clinicopathological features and prognosis of gastric cancer patients.MethodsSerum, gastric cancer and adjacent tissue samples from 90-patients with gastric-cancer treated by surgery and serum samples from 90-healthy adults were collected. The expression level of LINC01279 was analyzed by RT-PCR. The clinical baseline data of gastric cancer patients were obtained. Correlation between the expression level of LINC01279 and the clinicopathological characteristics of gastric cancer patients was assessed.ResultsLINC01279 was highly expressed in gastric cancer tissues and serum of gastric cancer patients (P < 0.05). The expression level of lncRNA 01279 was closely related to vascular invasion, nerve invasion, T-stage, lymph node metastasis, and advanced clinical-stage of gastric cancer (P < 0.05). The expression level was not correlated with gender, age, tumor size, location, and differentiation. There was a significant negative correlation between the expression of LINC01279 and the overall survival of gastric-cancer patients (P < 0.05).ConclusionLINC01279 is highly expressed in gastric-cancer tissues and serum, which is closely related to tumor-invasion. Serum LINC01279 is a better prognostic indicator of invasive cancer than current tumor markers.     

Gastric metastasis from breast cancer in male patient - Case report and literature review

IntroductionMale breast cancer has a low incidence, and its metastases are considered even rarer and a sign of seriousness for the patient. Breast metastases are difficult to diagnose even in female patients, with few cases of gastric metastasis described in the current literature.Presentation of caseMale patient, 54 years old, obese, diagnosed with breast cancer for 8 years, underwent 5 years of cancer follow-up. After this period, he began to experience epigastric pain and weight loss, among other symptoms. Endoscopy was performed, showing rounded elevated lesions with central depression. After anatomopathological and biochemical tests, a diagnosis of differentiated carcinoma as a metastasis of breast origin was concluded.DiscussionMBC is rare when compared to the incidence in females. Its risk factors differ between genders, and due to its rarity, there are few studies in the male population. This fact makes the evaluation of metastases more difficult. Gastric metastasis has a very low incidence even in women, approximately 8.9% of all breast cancer metastasis's locations. Other pathologies can mimic GM, always associating anatomopathological and biochemical tests. Oncological follow-up must always be carried out, and the possibility of screening must be evaluated.ConclusionDespite the rare incidence and little information in the literature, the association between MBC and GM should be considered. Currently, there is no guidance for conducting systematic screenings and treatment is usually palliative due to the severity of the disease.     

Solitary thyroid metastasis from colorectal cancer: Case report

Introduction and importanceThyroid metastasis of colorectal cancer is rare and the patient with thyroid metastasis has no symptoms early in the disease course. On the other hand, evaluation of thyroid is not generally included in the routine follow-up of colorectal cancer. Therefore, the diagnosis of thyroid metastasis of colorectal cancer may be delayed.Presentation of caseChest computed tomography revealed a nodule on the right lobe of the thyroid in 53-year-old woman diagnosed with sigmoid colon adenocarcinoma. This nodule was identified having as increased metabolic activity by ¹⁸F-fluorodeoxyglucose positron emission tomography-computed tomography and confirmed to be consisted of cystic and solid portions by ultrasonography. Fine needle aspiration cytology of the nodule revealed metastasis of colon cancer. The patient underwent laparoscopic anterior resection and a total thyroidectomy. The size of the thyroid tumor was 1.2 cm with free resection margin.DiscussionThe clinical features of thyroid metastasis from colorectal cancer are not typical. In addition, follow-up examinations of patients with colorectal cancer do not include imaging studies of the neck, so the diagnosis of thyroid metastases is delayed. The management strategies for thyroid metastasis from colorectal cancer include a total thyroidectomy without prophylactic neck lymph node dissection and chemotherapy. However, as the penetration of chemotherapeutic drugs into the thyroid is difficult, the effect on the thyroid is considered insignificant.ConclusionSurgical treatment should be considered for treatment of thyroid metastasis.