Adrenal metastasis secondary to papillary thyroid carcinoma

Differentiated papillary thyroid carcinoma is usually indolent. Distant metastases from papillary thyroid cancer are rare and associated with poor prognosis. To our knowledge there have been no reported cases of functioning adrenal metastases secondary to papillary carcinoma of the thyroid. Here we report a patient with papillary thyroid carcinoma where surveillance scanning with whole-body I-131 scan revealed a large, solitary adrenal metastasis. A 73-year-old woman was treated aggressively for a large papillary thyroid carcinoma. After fine-needle aspiration biopsy of the thyroid nodule, she underwent near-total thyroidectomy and postoperative treatment with 150 mCi of I-131. Nine months later, surveillance whole-body I-131 scanning revealed a large focus of uptake in the right adrenal gland. The patient underwent adrenalectomy and a papillary thyroid carcinoma metastasis was confirmed. To our knowledge this is the first description of a functioning papillary thyroid carcinoma metastatic to the adrenal.