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Journal of Medical Case Reports

Spontaneous hepatic hemorrhage as presentation of metastasized papillary thyroid carcinoma: a case report

Published in:
Authors
Jacob Thomasson
Bodil Andersson
Lo Hallin Thompson
Caroline Williamsson
Published in
Journal of Medical Case Reports | Issue 1/2024

Abstract

Background

Spontaneous hepatic hemorrhage is a rare condition, most commonly diagnosed in patients with hepatocellular carcinoma or hepatic adenomas, and is seldom caused by metastatic disease. In this case report, we present a patient with spontaneous hepatic hemorrhage due to hepatic metastasis of papillary thyroid carcinoma, an exceptionally rare occurrence.

Case presentation

The patient was a 77-year-old white male with a history of atrial fibrillation treated with apixaban. He presented at a local hospital with abdominal pain and nausea. A CT scan revealed a hepatic lesion in segment 3 with an adjacent hematoma. He was referred to our tertiary center and treated conservatively. Further evaluation revealed an intrathoracic goiter containing a tumorous process diagnosed as a papillary thyroid carcinoma (PTC), and the patient subsequently underwent thyroidectomy. A biopsy of the hepatic lesion confirmed it as a PTC metastasis. Due to worsening abdominal pain and anorexia, the patient underwent subacute hepatic segmental resection. Postoperatively, he developed iodine-refractory disease with disseminated metastasis and passed away 22 months after the initial admission.

Conclusions

To our knowledge, this is the first recorded case of metastasized papillary thyroid carcinoma presenting with spontaneous hepatic hemorrhage—adding to the list of rare causes for this condition.
Title
Spontaneous hepatic hemorrhage as presentation of metastasized papillary thyroid carcinoma: a case report
Authors
Jacob Thomasson
Bodil Andersson
Lo Hallin Thompson
Caroline Williamsson
Publication date
01-12-2024
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2024
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-024-04797-5
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Image Credits
Abdominal MRI of thyroid cancer patient with spontaneous hepatic hemorrhage/© 2024, Jacob Thomasson et al, J Med Case Reports, Colon cancer illustration/© (M) KATERYNA KON / SCIENCE PHOTO LIBRARY / Getty Images, CAR T-cell attacking cancer cells/© LoveLive/stock.adobe.com