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Thyroid nodule: not as clear-cut as it seems.

Benign etiologies and primary thyroid cancers are the most common causes of incidental thyroid nodules. Clinically evident metastases to the thyroid gland are not common and account for 2%-3% of thyroid cancers, though the incidence of thyroid metastases reaches 24% in autopsy studies.1 The most common clinically detected thyroid metastases originate from renal cell carcinoma (RCC; 48.1%).2 We report here a rare case of a man with clear-cell RCC with late recurrence in the thyroid gland as a solitary metastasis, 13 years after the primary diagnosis. The patient received neo-adjuvant targeted therapy with sunitinib, then underwent thyroidectomy. The surgical margins were positive, and the patient had adjuvant radiation therapy. He is currently on long-term surveillance.