Document Type : Case Reports


1 Dept. of Hematology and Oncology, Kermanshah University of Medical Sciences, Kermanshah, Iran

2 Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran

3 Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran


Colorectal cancer (CRC) metastasis to the thyroid gland is rare. Here wereport a 45 yr-old man in western Iran referred to Hematology Clinic, Kermanshah city, Iran in March 2014 with complaint of exertional dyspnea, multi-nodular goiter as well as complaint of exertional dyspnea, and multi-nodular goiter. His history included a low anterior resection of rectum in 9 months ago for a high-risk stage II rectal adenocarcinoma. He did not show clinical signs of hyperthyroidism other than thyroid enlargement. In thyroid nodule the FNA cytology, pathology reported anaplastic thyroid malignancy. Pathologists reported final diagnosis of colorectal metastasis of thyroid gland. Then due to metastatic pattern of disease, his pathology was evaluated for RAS molecular assay. In the patients of metastatic CRC, RAS testing is the first step to identify those patients that could benefit from anti-EGFR monoclonal antibodies treatment.


How to cite this article:
Payandeh M, Sadeghi M, Sadeghi E. The Report of KRAS Mutation and NRAS Wild-Type in a Patient with Thyroid Metastasis from Colon Cancer: a Rare Case Report. Iran J Pathol. 2016: 11(1): 71-75.


Main Subjects

  1. Hanna WC, Ponsky TA, Trachiotis GD, Knoll SM. Colon cancer metastatic to the lung and the thyroid gland. Arch Surg 2006 Jan;141(1):93-6.
  2. Cheung WY, Brierley J, Mackay HJ. Treatment of rectal cancer metastases to the thyroid gland: report of two cases. Clin Colorectal Cancer 2008 Jul;7(4):280-2.
  3. Cherk MH, Moore M, Serpell J, Swain S, Topliss DJ. Metastatic colorectal cancer to a primary thyroid cancer. World J Surg Oncol 2008 Nov 11;6:122.
  4. Goatman C, Goldsmith PJ, Antonopoulos V, Ali B. Metastasis of colorectal adenocarcinoma to the thyroid: a case report and review of the literature. Case Rep Surg 2012;2012:179407.
  5. Grabocka E, Pylayeva-Gupta Y, Jones MJ, Lubkov V, Yemanaberhan E, Taylor L, et al. Wild-type H- and N-Ras promote mutant K-Ras-driven tumorigenesis by modulating the DNA damage response. Cancer Cell 2014 Feb 10;25(2):243-56.
  6. Nakamura K, Nozawa K, Aoyagi Y, Ishihara S, Matsuda K, Fukushima J, et al. A case report of thyroid gland metastasis associated with lung metastasis from colon cancer. Tumori 2011 Mar-Apr;97(2):229-32.
  7. Cozzolino I, Malapelle U, Carlomagno C, Palombini L, Troncone G. Metastasis of colon cancer to the thyroid gland: a case diagnosed on fine-needle aspirate by a combined cytological, immunocytochemical, and molecular approach. Diagn Cytopathol 2010 Dec;38(12):932-5.
  1. van Krieken JH, Jung A, Kirchner T, Carneiro F, Seruca R, Bosman FT, et al. KRAS mutation testing for predicting response to anti-EGFR therapy for colorectal carcinoma: Proposal for an European quality assurance program. Virchows Arch 2008;453:417–31.
  1. Santini D, Loupakis F, Vincenzi B, Floriani I, Stasi I, Canestrari E, et al. High concordance of KRAS status between primary colorectal tumors and related metastatic sites: Implications for clinical practice. Oncologist 2008;13:1270–75.
  2. Bagadi SB, Sanghvi M, Nair SB, Das BR. Combined mutational analysis of KRAS, NRAS and BRAF genes in Indian patients with colorectal carcinoma. Int J Biol Markers 2012 Jan-Mar;27(1):27-33.
  3. Patel GS, Karapetis CS. Personalized treatment for advanced colorectal cancer: KRAS and beyond. Cancer Manag Res 2013 Nov 21;5:387-400.
  4. HRAS and NRAS Regulate the DNA Damage Response in KRAS-mutant Tumors.Cancer Discovery 2014 Apr, 4(4):388.
  5. Kawamoto Y, Tsuchihara K, Yoshino T, Ogasawara N, Kojima M, Takahashi M, et al. KRAS mutations in primary tumours and post-FOLFOX metastatic lesions in cases of colorectal cancer. Br J Cancer 2012 Jul 10;107(2):340-4.
  6. Bayrak R, Yenidünya S, Haltas H. Cytokeratin 7 and cytokeratin 20 expression in colorectal adenocarcinomas. Pathol Res Pract 2011 Mar 15;207(3):156-60.
  7.  Boggaram V. Thyroid transcription factor-1 (TTF-1/Nkx2.1/TITF1) gene regulation in the lung. Clin Sci (Lond) 2009 Jan;116(1):27-35.