Pulmonary epithelioid hemangioendothelioma coexistent with pulmonary metastasis of thyroid cancer

We report a 45-year-old man with epithelioid hemangioendothelioma (EH) and simultaneous pulmonary metastasis of thyroid cancer in his lung. Thyroid ca ncer, and multiple small nodules in both lungs were noted. He underwent tot al thyroidectomy followed by radiotherapy with I-131. However, I-131 scinti graphy showed poor uptake of radionuclide in the nodules, and the size of t he nodules remained unchanged. The diagnostic thoracoscopic biopsy showed t wo types of nodules, some were positive for thyroglobulin and cytokeratin, and others were reactive for factor VIII. The former nodules were diagnosed as pulmonary metastases of thyroid cancer, and the latter EH.