This case report describes the rare coexistence of pulmonary epithelioid hemangioendothelioma and pulmonary metastasis of thyroid cancer, emphasizing the need for biopsy when nodules do not respond to targeted therapy.
May warrant biopsy for nonresponsive nodules; leaves open prevalence and implications of dual pulmonary pathologies.
We report a 45-year-old man with epithelioid hemangioendothelioma (EH) and simultaneous pulmonary metastasis of thyroid cancer in his lung. Thyroid cancer, and multiple small nodules in both lungs were noted. He underwent total thyroidectomy followed by radiotherapy with 131I. However, 131I scintigraphy showed poor uptake of radionuclide in the nodules, and the size of the nodules remained unchanged. The diagnostic thoracoscopic biopsy showed two 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.
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Machida et al. (2001) studied this question.
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