Malignant Melanoma metastacizing to the Thyroid Gland: A Case Report and Review of the Literature

Oral presentation 2006 AAO-H&NS Annual Meeting Toronto, Canada September 17-20, 2006. Objectives: The thyroid gland is a relatively uncommon site for secondary malignancy. Even lesscommon is metastasis of malignant melanoma to the thyroid gland. We present a case of malignantmelanoma metastatic to the thyroid gland presenting as thyroid enlargement. Study Design: This is a case report which utilizes chart review, intraoperative photographs,radiographic images, and pathology slides. Methods: A 68 year old patient with no prior evidence of primary skin melanoma presented witha neck mass which tested positive for melanoma. A year and a half following modified radical neckdissection, the patient presented with a diffusely enlarged thyroid gland from which fine needleaspiration revealed metastatic malignant melanoma. Results: A few months following this, the patient began having seizures and was found on MRIto have metastatic disease to the brain. He developed ventilator dependent respiratory failure andrequired a subtotal thyroidectomy for the placement of a tracheostomy tube. Conclusions: Patients with a history of malignancy and a thyroid nodule present a diagnosticdilemma—is it benign, a new primary, or distant metastasis? Review of this case and the literaturestrengthens the argument that any patient with a history of malignancy and a thyroid mass shouldbe considered as having metastasis until proven otherwise