Miliary Pulmonary Metastasis

Axial CT image shows multiple small 2-3 mm nodules (arrows) throughout both lungs in a patient with thyroid cancer.

Facts: Miliary Metastasis

• Uncommon form of pulmonary metastasis
• Most commonly due to thyroid cancer, renal cell carcinoma and melanoma

Pulmonary Metastasis in Thyroid Cancer

• Distant metastasis (lung and bone) found in 10-15% of patients with differentiated thyroid cancer
• Lung metastasis is most frequent in young patients with papillary carcinoma, and lungs are almost the only site of distant metastasis in children
• Variables found to be adversely affected survival: extensive metastasis, older age at metastasis, absent I-131 uptake of metastasis, and moderately differentiated follicular cell carcinoma

Our case: thyroid cancer with miliary metastasis

References:

1. Biersack HJ, Grunwald F. Thyroid cancer, 2nd ed, 2005.

2. Schlumberger MJ. Papillary and follicular thyroid carcinoma. N Eng J Med 1998;338:297-306.