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Liu Y, Liu X, Chen X, Zhou L, Gao X, Yu H. Follicular thyroid carcinoma presenting with multiple skull metastases on CT and MRI: A case report and literature review. Radiol Case Rep 2021; 16:3260-3265. [PMID: 34484527 PMCID: PMC8403711 DOI: 10.1016/j.radcr.2021.07.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 07/21/2021] [Accepted: 07/24/2021] [Indexed: 11/24/2022] Open
Abstract
Although the incidence of thyroid carcinoma has increased in recent years, follicular thyroid carcinoma with bone metastasis as the first symptom remains rare. Here, we report a case of occult follicular thyroid carcinoma in a 65-year-old female patient admitted to hospital with cerebrovascular disease. Computed tomography findings suggested a diagnosis of meningioma; however, magnetic resonance imaging results showed multiple skull bone destruction with soft tissue masses on the left side of the skull. After surgical resection, the pathology results revealed skull metastasis of follicular thyroid carcinoma. We present this case not only because of the diagnostic challenge it posed, but also because the patient had multiple skull metastases from follicular thyroid carcinoma.
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Affiliation(s)
- Ying Liu
- Department of CTMR, Ningcheng County Central Hospital, Ningcheng Inner Mongolia 024200, China
| | - Xianchen Liu
- Department of CTMR, Ningcheng County Central Hospital, Ningcheng Inner Mongolia 024200, China
| | - Xuezhi Chen
- Department of CTMR, Ningcheng County Central Hospital, Ningcheng Inner Mongolia 024200, China
| | - Lianjun Zhou
- Department of CTMR, Ningcheng County Central Hospital, Ningcheng Inner Mongolia 024200, China
| | - Xiaoling Gao
- Department of CTMR, Ningcheng County Central Hospital, Ningcheng Inner Mongolia 024200, China
| | - Hao Yu
- Department of CTMR, Ningcheng County Central Hospital, Ningcheng Inner Mongolia 024200, China
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Ghartimagar D, Ghosh A, Shrestha MK, Thapa S, Talwar OP. Histopathological Spectrum of Non-Neoplastic and Neoplastic Lesions of Thyroid: A Descriptive Cross-sectional Study. ACTA ACUST UNITED AC 2020; 58:856-861. [PMID: 34506431 PMCID: PMC7775000 DOI: 10.31729/jnma.5038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Indexed: 11/26/2022]
Abstract
Introduction: Thyroid gland lesions are the most common endocrine disorders encountered globally. Diseases of the thyroid gland present with either an alteration of hormone secretion or as an enlargement of the thyroid gland. The objective of the study is to find the frequency of different thyroid lesions. Methods: A descriptive cross-sectional study was conducted at Manipal Teaching Hospital, Pokhara from Jan 2005 to Jan 2020. Ethical approval was taken from the Institutional Review Committee (Ref: 330). Patients who had undergone thyroidectomy procedures for both non-neoplastic and neoplastic thyroid lesions were enrolled. Convenient sampling was done. IBM Statistical Package for Social Sciences version 21 and Microsoft Excel were used. Results: Out of 345 thyroidectomy specimens, 246 (71.3%) cases of non-neoplastic lesions, and 99 (28.69%) cases of neoplastic lesions were present. There were 54 males and 291 females with a male to female ratio of 1:5.4. The age ranged from 9 to 76 years with a mean age of 43.67 years. In non-neoplastic lesions, the predominant lesion was the colloid goiter with 205 (83.33%) cases followed by Grave's disease and lymphocytic thyroiditis with 14 (5.69%) cases each. In neoplastic lesions, papillary carcinoma was the commonest lesion with 56 (56.56%) cases followed by follicular carcinoma with 14 (14.14%) cases and follicular adenoma with 13 (13.13%) cases. There were also 9 (9.09%) cases of anaplastic carcinoma in neoplastic lesions. Conclusions: Colloid goiter and papillary carcinoma was the most commonly encountered non-neoplastic and neoplastic lesion with a female predominance. Rare tumors like anaplastic carcinoma, papillary carcinoma, and follicular carcinoma with anaplastic transformation were also encountered.
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Affiliation(s)
| | - Arnab Ghosh
- Department of Pathology, Manipal College of Medical Science, Pokhara, Nepal
| | | | - Sushma Thapa
- Department of Pathology, Manipal College of Medical Science, Pokhara, Nepal
| | - Om Prakash Talwar
- Department of Pathology, Manipal College of Medical Science, Pokhara, Nepal
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3
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Concurrent Hip Pain and Skull Lump as the First Manifestations of a Silent Follicular Thyroid Carcinoma. REPORTS 2020. [DOI: 10.3390/reports3040027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Follicular thyroid carcinoma is a slowly growing cancer with a generally good long-term prognosis. Distant metastasis from follicular thyroid cancer usually occurs in the lung and bones following a long period after diagnosis and treatment for primary cancer. Occult skull metastasis as the first presentation at diagnosis from follicular thyroid cancer is relatively rare. A 51-year-old woman presented with intermittent pain in her right hip that was treated due to the intensely progressed pain, motor weakness, and difficulty walking. The patient was then referred due to swelling in the forehead. Further evaluation revealed that the frontal swelling and the pathological femoral fractures were manifestations of distant metastases from follicular thyroid cancer. In the presence of swelling in the skull, the metastatic lesion should be considered as a differential diagnosis from a silent primary cancer. This report will be beneficial for general practitioners, surgeons, and internists to recognize unusual distant metastatic manifestations from silent differentiated thyroid cancer.
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Sheikh AB, Akhtar A, Tariq U, Sheikh AAE, Siddiqui FS, Bukhari MM. Skull Metastasis Extending to the Superior Sagittal Sinus: An Unfamiliar Presentation of Papillary Thyroid Carcinoma. Cureus 2018; 10:e2738. [PMID: 30087814 PMCID: PMC6075641 DOI: 10.7759/cureus.2738] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Thyroid cancer is the most common endocrine cancer in the world, with a rising global incidence over the last three decades. Papillary thyroid cancer (PTC) is the most common type of thyroid neoplasia, accounting for 74%-80% of all cases. Skull metastasis from a differentiated thyroid malignancy is a rare occurrence, while a subsequent dural involvement is even more inimitable. As such, a clinician requires a high degree of clinical suspicion and resultant radiographic evidence in order to make the diagnosis. Here we present the case of a 54-year-old male patient who presented with a pathological fracture of his right humerus, a midline frontal bone swelling and an asymptomatic neck mass. Further workup revealed follicular variant papillary thyroid carcinoma (FV-PTC) with distant metastasis to the calvarium. The conventional therapy for metastatic PTC includes a total thyroidectomy, removal of resectable metastatic lesions and a supplementation with radioactive iodine (RAI) and/or external beam radiation at the sites of the metastases. This case and our literature review illustrate that skull metastases should be considered in the clinical course of PTC so that appropriate management can be started.
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Affiliation(s)
| | - Aisha Akhtar
- Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, USA
| | - Usman Tariq
- Research Assistant, Yale University School of Medicine, New Haven, USA
| | | | | | - Marvi M Bukhari
- Internal Medicine, Shifa College Of Medicine, Islamabad, PAK
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Yari N, Espino Barros Palau A, Morgan ML, Levine NB, Lee AG. Metastatic Papillary Thyroid Carcinoma Presenting as Abducens Palsy Complicated by Ocular Neuromyotonia. Neuroophthalmology 2016; 40:97-101. [PMID: 27928392 DOI: 10.3109/01658107.2015.1132742] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 12/12/2015] [Accepted: 12/13/2015] [Indexed: 11/13/2022] Open
Abstract
Papillary thyroid carcinoma (PTC) is a type of well-differentiated thyroid cancer that accounts for the majority of thyroid malignancies. The prognosis of PTC is very good and distant metastases are rare, especially to the skull base. The authors report the case of a 47-year-old woman with biopsy-proven PTC treated with surgery and radiation therapy who presented with headache and diplopia after 5 years and was found to have clivus and cavernous sinus metastasis. Following radiation therapy for her skull base and cavernous sinus lesion, she subsequently developed sixth nerve ocular neuromyotonia. Possible causes and treatments are reviewed.
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Affiliation(s)
- Niloofar Yari
- Department of Neurology, Baylor Scott and White Health , Temple, Texas, USA
| | | | - Michael L Morgan
- Department of Ophthalmology and Visual Sciences, University Hospitals Eye Institute, Case Western Reserve University School of Medicine , Cleveland, Ohio, USA
| | | | - Andrew G Lee
- UT MD Anderson Cancer Center, Houston, Texas, USA; Department of Ophthalmology, Houston Methodist Hospital, Houston, Texas, USA; Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medical College, Houston, Texas, USA; University of Texas Medical Branch, Galveston, Texas, USA
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Al-Qahtani KH, Tunio MA, Al Asiri M, Fatani H, Bayoumi Y. Calvarium and dura mater as delayed sites of distant metastasis from papillary thyroid carcinoma. Int Med Case Rep J 2015; 8:251-4. [PMID: 26527901 PMCID: PMC4621188 DOI: 10.2147/imcrj.s86183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Skull calvarium and dura mater are rare sites of distant metastasis, and mostly have been reported in lung, breast, and prostate malignancies. However, the calvarial and dural metastases from papillary thyroid cancer (PTC) are rare entities and pose diagnostic and therapeutic challenges. To date, only seven cases of calvarial metastasis with intracranial extension from PTC have been reported in literature. However, true dural metastasis from PTC has not yet been reported. Case presentation A 65-year-old Saudi woman presented with 6 months history of painful posterior scalp lump, 7 years after initial diagnosis of PTC. Computed tomography and magnetic resonance imaging showed occipitoparietal calvarial lesion with massive intracranial extension. Another para-sagittal lesion was found at the top of corpus callosum mimicking a meningioma. Histopathology of para-sagittal lesion and the biopsy of calvarial mass confirmed the diagnosis of metastatic PTC. After surgical resection, residual tumors were treated with postoperative intensity-modulated radiation therapy. At 13 months of follow-up, patient was alive and without any signs of recurrence. Conclusion Calvarial and dural metastases from PTC are extremely rare clinical entities. Surgical resection followed by postoperative radiotherapy is the treatment of choice. However, for such cases, multidisciplinary approach can prolong the treatment outcome and survival.
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Affiliation(s)
- Khalid Hussain Al-Qahtani
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mutahir A Tunio
- Radiation Oncology Department, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Mushabbab Al Asiri
- Radiation Oncology Department, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Hanadi Fatani
- Histopathology Department, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Yasser Bayoumi
- Radiation Oncology Department, National Cancer Institute, Cairo, Egypt
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Shen J, Wang S, Zhao X, Shao X, Jiang X, Dai Y, Xu S, Pan X. Skull metastasis from follicular thyroid carcinoma: report of three cases and review of literature. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2015; 8:15285-15293. [PMID: 26823882 PMCID: PMC4713668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Accepted: 10/21/2015] [Indexed: 06/05/2023]
Abstract
Three patients' medical history, clinical manifestation, imaging characteristic, therapy and prognosis of calvaria metastasis from follicular thyroid carcinoma (FTC) in our hospital were retrospectively analyzed by reviewing medical literature. In case one, the tumor in frontal bone and fossa orbital was total resected, no further treatment was performed, the patient gave up on therapy and died of extensive metastasis at 22 months after the initial operation. In case two, the tumor in parietal and occipital bone was total resected, the subtotal resection of bilateral thyroid gland and isthmus was performed and combined with therapy of Levothyroxine and (131)I radio-iodine therapy, no evidence of tumor recurrence at 30 months after the primary operation. In case three, the tumor in occipital bone was gross total resected, total resection of bilateral thyroid gland and clearance of lymph node was performed after two months, adjunctive therapy with Levothyroxine, (131)I radio-iodine and skull radiotherapy, no evidence of tumor recurrence at 21 months after the primary operation. Correct diagnosis of calvaria metastasis from FTC preoperative is difficult because it's rarity, patients can survive for years after synthetic therapy including total resection of metastatic tumor, radical operation of thyroid carcinoma, adjunctive therapy of Levothyroxine, (131)I radio-iodine and skull radiotherapy.
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Affiliation(s)
- Jun Shen
- Department of Neurosurgery, Yi-Ji Shan Hospital of Wannan Medical CollegeWuhu, Anhui, China
| | - Sufen Wang
- Department of Pathology, Yi-Ji Shan Hospital of Wannan Medical CollegeWuhu, Anhui, China
| | - Xintong Zhao
- Department of Neurosurgery, Yi-Ji Shan Hospital of Wannan Medical CollegeWuhu, Anhui, China
| | - Xuefei Shao
- Department of Neurosurgery, Yi-Ji Shan Hospital of Wannan Medical CollegeWuhu, Anhui, China
| | - Xiaochun Jiang
- Department of Neurosurgery, Yi-Ji Shan Hospital of Wannan Medical CollegeWuhu, Anhui, China
| | - Yi Dai
- Department of Neurosurgery, Yi-Ji Shan Hospital of Wannan Medical CollegeWuhu, Anhui, China
| | - Shanshui Xu
- Department of Neurosurgery, Yi-Ji Shan Hospital of Wannan Medical CollegeWuhu, Anhui, China
| | - Xianwen Pan
- Department of Neurosurgery, Yi-Ji Shan Hospital of Wannan Medical CollegeWuhu, Anhui, China
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