Introduction differentiated thyroid carcinoma presents with distant metastasis in 4% of cases, usually occurring in the lungs, bones and thoracic lymph nodes. Pancreatic involvement is extremely rare, with few cases reported in the literature. Case report A 47-yearsold female patient presented abdominal pain. She had a history of papillary thyroid carcinoma surgically resected in 2009. After 10 years, computed tomography revealed hepatic lesions suggestive of secondary involvement and a solid mass in the pancreatic head. Endoscopic ultrasound fine-needle aspiration was performed in a heterogeneous hypoechoic mass located at pancreatic head. Cell block with immunohistochemistry was positive for thyroglobulin, suggesting papillary thyroid carcinoma metastasis. The patient still survives at present, treating metastasis with Cabozantinib. Conclusion endoscopic ultrasound fine-needle aspiration is a minimally invasive and accurate method of sampling lesions of the pancreas. In combination with clinical history and immunohistochemistry, can confirm diagnosis and define management.
Andressa A Machado, Luciano Lenz, Regina B Domingues, Gustavo RA Lima, Iatagan R Josino, Martin AC Cordero, Adriana V Safatle-Ribeiro, Bruno C Martins, Caterina MPS Pennacchi, Carla C Gusmon, Gustavo A Paulo, Marcelo S Lima, Elisa R Baba, Fábio S Kawaguti, Ricardo S Uemura, Fauze Maluf-Filho