[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-342421-105":59,"doc-detail-342421-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","case-report-rare-presentation-of-double-primary-malignancies-of-the-lung-and-thyroid-a-difficult-diagnosis","Case report - Rare presentation of double primary malignancies of the lung and thyroid - a difficult diagnosis","","Rare double primary malignancies of the lung and thyroid are documented in a 49-year-old woman with poor outcome, dying 2 years after diagnosis. She was found to have BRAFV600E-mutant metastatic papillary thyroid carcinoma and ALK-fusion-positive metastatic lung adenocarcinoma, presenting with multifocal thyroid lesions and suspicious cervical lymph nodes. Imaging showed hypermetabolic pulmonary and nodal involvement with bone destruction. Histology and immunohistochemistry identified mixed metastatic components across cervical nodes, leading to multidisciplinary targeted therapy but an unfavorable prognosis.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/case-report-rare-presentation-of-double-primary-malignancies-of-the-lung-and-thyroid-a-difficult-diagnosis/342421/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/case-report-rare-presentation-of-double-primary-malignancies-of-the-lung-and-thyroid-a-difficult-diagnosis/342421.png","ImageObject",300,407,{"name":92,"@type":93},"Logic","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-09-23","2026-09-22",true,{"@type":102,"interactionType":103,"userInteractionCount":81},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What are multiple primary cancers (MPCs) and what criteria are used for diagnosis?","Question",{"text":112,"@type":113},"MPCs are defined as two or more primary malignant tumors occurring simultaneously or successively in one or more organs of the same patient. Diagnosis requires that each tumor is malignant, confirmed histopathologically, occurs at different sites without continuity, and that metastatic or recurrent tumors are excluded.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What malignancies were identified in this patient?",{"text":117,"@type":113},"The patient had BRAFV600E-mutant metastatic papillary thyroid carcinoma and ALK-fusion-positive metastatic lung adenocarcinoma.",{"name":119,"@type":110,"acceptedAnswer":120},"Why was the diagnosis considered difficult in this case?",{"text":121,"@type":113},"Suspicious cervical lymph nodes initially suggested metastatic PTC, while later findings from biopsies and imaging demonstrated additional lung adenocarcinoma involvement. One enlarged cervical lymph node contained tumor components of both PTC and lung adenocarcinoma, complicating interpretation.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},342421,1790141691,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":81,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":34,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144},1099513958762,"https://ap-avatar.wpscdn.com/avatar/1000023916a998db790?x-image-process=image/resize,m_fixed,w_180,h_180&k=1784791008015729253","TYPE Case Report  \nPUBLISHED 08 January 2024 DOI 10.3389/fonc.2023.1251492  \nOPEN ACCESS  \nEDITED BY  \nJason Chia-Hsun Hsieh,  \nNew Taipei Municipal TuCheng Hospital, Taiwan  \nREVIEWED BY  \nStefan Sponholz,  \nAgaplesion Markus Krankenhaus, Germany Wing-Keen Yap,  \nChang Gung Memorial Hospital, Taiwan  \n*CORRESPONDENCE Xin Jiang  \n [2339571202@qq.com](2339571202@qq.com)  \nRECEIVED 01 July 2023  \nACCEPTED 11 December 2023  \nPUBLISHED 08 January 2024  \nCITATION  \nChen S-P, Li P, Pan Y-F and Jiang X (2024) Case report: Rare presentation of double primary malignancies of the lung and thyroid: a difficult diagnosis.  \nFront. Oncol. 13:1251492 .  \ndoi: 10.3389/fonc.2023.1251492  \nCOPYRIGHT  \n© 2024 Chen, Li, Pan and Jiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.  \nCase report: Rare presentation of double primary malignancies of the lung and thyroid: adifficult diagnosis  \nShun-Ping Chen 1, Peng Li 2, Yi-Fei Pan 3 and Xin Jiang 1*  \n1 Department of Ultrasonography, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China, 2 Department of Pathology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China, 3 Department of Colorectal and Anal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China  \nThis report describes a rare case of double primary cancer in a female patient aged 49 years who died 2 years after diagnosis. The patient was diagnosed with BRAFV600E-mutant metastatic papillary thyroid carcinoma (PTC) and ALK fusionpositive metastatic lung adenocarcinoma. She presented with multifocal thyroid lesions and underwent radical thyroidectomy and bilateral cervical lymphadenectomy. Thyroid ultrasound revealed the presence of five hypoechoic nodules with irregular margins and microcalcifications; an irregular inhomogeneous hypoechoic level IV cervical lymph node was also found on the right side. Histological analysis confirmed the presence of metastatic PTC, and the tumor tested positive for the BRAFV600E mutation. Ultrasound of the neck, which was performed 4 months postdischarge, revealed enlargement of the left-sided cervical lymph nodes; a biopsy from these nodes confirmed a diagnosis of metastatic PTC. Positron emission tomography-computed tomography scans revealed the presence of multiple pulmonary hypermetabolic foci scattered across bilateral lung fields. Multiple hypermetabolic foci were also observed in the lymph nodes on both sides of the neck, axillae, and mediastinum; in addition, there was evidence of bone destruction with hypermetabolic foci. Supplementary reports from the histological and immunohistochemical analyses of cervical lymph node tissue obtained during primary surgery confirmed the presence of metastatic PTC and poorly differentiated lung adenocarcinoma. In particular, one enlarged cervical lymph node located on the right side of the neck demonstrated tumor components of both PTC and lung adenocarcinoma. Pathological analysis of axillary lymph node puncture biopsy confirmed the presence of metastatic lung adenocarcinoma, and gene analysis revealed the presence ofALK fusion. The patient received targeted therapy based on a multidisciplinary discussion. However, she had a poor prognosis and died 2 years after the diagnosis. The initial thyroid ultrasound findings were reviewed retrospectively; the findings suggested that the possibility of double primary cancers should be considered in cases where the enlarged cervical lymph nodes are highly suspicious of PTC and present as inhomogeneous hypoechoic masses with irregular morphology.  \nKEYWORDS  \ndouble c","cbCaicVSBVAVkbi6","https://ap.wps.com/l/cbCaicVSBVAVkbi6","pdf",3219793,"English","# Introduction\n## Case description","[{\"question\":\"What are multiple primary cancers (MPCs) and what criteria are used for diagnosis?\",\"answer\":\"MPCs are defined as two or more primary malignant tumors occurring simultaneously or successively in one or more organs of the same patient. Diagnosis requires that each tumor is malignant, confirmed histopathologically, occurs at different sites without continuity, and that metastatic or recurrent tumors are excluded.\"},{\"question\":\"What malignancies were identified in this patient?\",\"answer\":\"The patient had BRAFV600E-mutant metastatic papillary thyroid carcinoma and ALK-fusion-positive metastatic lung adenocarcinoma.\"},{\"question\":\"Why was the diagnosis considered difficult in this case?\",\"answer\":\"Suspicious cervical lymph nodes initially suggested metastatic PTC, while later findings from biopsies and imaging demonstrated additional lung adenocarcinoma involvement. One enlarged cervical lymph node contained tumor components of both PTC and lung adenocarcinoma, complicating interpretation.\"}]","Case report - Rare presentation of double primary malignancies of the lung and thyroid - a difficult diagnosis | PDF",1790046567,18]