Hemorrhagic pleural effusion from metastatic papillary thyroid carcinoma with occult primary tumour

ABSTRACT

We present a case with left sided chest pain associated with shortness of breath due to hemorrhagic effusion proven by open pleural biopsy to be secondary to metastatic papillary thyroid carcinoma. A pleural aspirate and needle biopsy were not helpful. An ultrasound of the thyroid and subsequent thyroidectomy established the primary as a small sclerotic papillary carcinoma in the left thyroid lobe. Papillary carcinoma of the thyroid usually follows an indolent course characterized by slow local growth and possible cervical lymph node metastases but usually absent distant metastases. Several reports in the literature suggest that metastases to bone and lung may occur infrequently. Upon reviewing the literature, we found only two case reports of papillary carcinoma of the thyroid presenting with symptomatic pleural effusions