Thyroid metastasis from intraductal papillary-mucinous carcinoma of the pancreas - A case report

BACKGROUND: Intraductal papillary-mucinous carcinoma (IPMC) of the pancreas is a newly identified clinicopathologic entity of the exocrine pancreas. I t has been considered a slowly growing and less-aggressive carcinoma with a favorable prognosis. There have been only a few documents reporting its di stant metastasis and cytologic features, with no report of thyroid metastas is until the present. CASE: A case of IPMC occurred in a 45-year-old male, who was admitted with rapid growth and tenderness of the thyroid. Abdominal computed tomography s howed the typical cystic dilatation of IPMC with adjacent organ metastasis. Fine needle aspiration of the thyroid yielded papillary fronds of carcinom a cells with nuclear pleomorphism, abundant cytoplasm and prominent nucleol i in a mucinous background. Immunohistochemical findings from the skin and thyroid characterized the papillary-mucinous carcinoma as having originated in the pancreas. CONCLUSION:This case suggests that papillary carcinoma fronds aspirated fro m the thyroid should be further differentiated from the primary site and th at a pleomorphic nucleus in a mucinous background is a useful feature to ex clude a thyroid origin. Before this, distant metastasis of IPMC to the skin and thyroid has not been reported. The prognosis of IPMC with wide, distan t metastasis at an advanced stage is poor.