Case Report

Uncommon first diagnosis of metastatic papillary thyroid carcinoma with “signet-ring” cells morphology through pericardial effusion

Angeliki Cheva, Sokratis Tsagkaropoulos*, Panagiotis Pepis, Antonia Syrnioti and Christoforos Foroulis

Published: 20 January, 2022 | Volume 6 - Issue 1 | Pages: 005-008

Malignant pericardial effusion is a usual and crucial exacerbation in malignancies. In some cases, pericardial effusion may be the first manifestation of the disease. Neoplastic pericarditis is extremely rare in thyroid cancer. Hereby, we describe the case of a 54-year-old man submitted to the hospital for chest pain and dyspnea. Clinical and radiological examinations were suggestive of pericardial effusion and mediastinal lymphadenopathy. The patient underwent pericardial drainage and surgical biopsy of a paratracheal lymph node. Pericardial biopsies were also taken. Histology study was compatible with metastatic papillary thyroid carcinoma with “signet-ring” cell morphology. Extended study of thyroid gland and function was performed and he was referred to oncologists for further treatment. 
Clinical presentation and histology are discussed emphasizing the rare correlation between pericardial pathology and metastatic thyroid carcinomas as the first diagnosis. Histopathologic findings of “signet-ring” cell morphology are very challenging for a differential diagnosis between thyroid carcinoma and other metastatic adenocarcinomas.

Read Full Article HTML DOI: 10.29328/journal.acr.1001057 Cite this Article Read Full Article PDF


Papillary thyroid carcinoma; Pericardial effusion; Metastatic adenocarcinoma; Signet ring cell thyroid carcinoma; Lymphadenopathy


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