July, 2019/ Vol 5/ Issue 7 Print ISSN: 2456-9887, Online ISSN: 2456-1487 Case Report Pathology Update: Tropical Journal of Pathology & Microbiology Available online at: www.medresearch.in 461 | Page Synchronous primary cancer of the thyroid and breast Rakshitha H.M. 1 , Suma M.N. 2 , Arjunan R. 3 , Malathi M. 4 , Priya D. 5 , Premalata C.S. 6 1 Dr. Rakshitha H.M., 2 Dr. Suma M.N., 3 Dr. Ravi Arjunan, Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, 4 Dr. Malathi M, 5 Dr. Priya D., 6 Dr. Premalata C.S.; 1,2,4,5,6 authors are attached with Department of Pathology, Kidwai Memorial Institute of Oncology, Bangalore, India Corresponding Author: Dr. Rakshitha H.M., Department of Pathology, Kidwai Memorial Institute of Oncology, Bangalore, India, E-mail: rakshita.201@gmail.com ………………………………………………………………………………………………………………………………... Abstract Background: The present case is of a synchronous primary classical thyroid carcinoma and primary ductal carcinoma of the breast in a 57 year old lady. Though the incidence of both thyroid cancer and breast cancer have been rising in recent years, it is very rare to find a single person with both of these cancers. Case summary: Patient underwent total thyroidectomy and right breast lump excision. Post operative histopathological examination identified papillary carcinoma thyroid, classical type, of the right lobe with metastasis to central compartment lymph nodes and invasive ductal carcinoma of the right breast. Now the patient is on regular follow up. Thus the aim of the current report was to improve the understanding of synchronous primary tumors of the thyroid and breast by presenting a review of the associated literature regarding breast and thyroid carcinoma. Conclusion: Although synchronous primary tumors of the thyroid and breast are very rare, they remain a possibility, therefore more attention should be paid to this cancer. Keywords: Synchronous, FNAC, papillary thyroid ………………………………………………………………………………………………………………………………... Introduction Synchronous malignancy is two or more histologically different malignancies detected within 6 months of the diagnosis of the first primary malignancy. Certain criteria have been laid down to diagnose synchronous malignancy; for example both the tumors should be malignant and neither should be a metastasis from the other, and the tumors should be separate from each other in terms of microscopic and morphologic features. The relationship and coincidence of breast cancer with thyroid disorders is a subject of extensive debate and controversy. Many studies have shown that thyroid diseases are common among women with breast cancer [1]. Breast carcinoma and thyroid carcinoma are the two most common malignancies that occur in women. However, synchronous primary tumors of the thyroid and breast are very rare in clinical practice. Although differentiated thyroid and breast cancer carry a lower risk of death or disease recurrence than other malignancies, their incidences have been steadily increasing for at least 2 decades [1], and they have become the most common malignancies in females [2, 3]. Dual malignancy was first reported by Billroth in 1889 [4]. Here in, the present case report was a rare case of a 53 year old female who was diagnosed with synchronous primary papillary thyroid carcinoma and invasive ductal cancer of the breast. Ghosh et al also reported a rare case of a synchronous anaplastic carcinoma thyroid with ductal carcinoma breast [4]. Case Report In the month of May 2018, a 57 year old postmenopausal lady presented to the surgical oncology OPD with complaints of swelling in front of the neck for past one year. She had incidentally noticed a lump in the right breast for one month duration. On clinical examination the swelling in the neck moved with deglutition and overlying skin was intact. Local examination of the breast revealed no discharge from the nipple /retraction of the nipple. USG neck revealed, a large heteroechoic lesion in the right lobe of thyroid measuring 2.8X3 cms with vascularity and calcifications within, peripheral hypoechoic halo appears disrupted at some places. CT neck revealed diffuse enlargement of thyroid gland, a hypodense lesion noted in right lobe of thyroid measuring 3.5X3.3X4.3 cm. Bilateral mammography was done and revealed BIRADS IV-A in right breast and BIRADS- I in left breast. Manuscript received: 4 th July 2019 Reviewed: 14 th July 2019 Author Corrected: 20 th July 2019 Accepted for Publication: 24 th July 2019