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.
Highlights
Follicular thyroid carcinoma is considered an indolent tumor with a favorable clinical outcome unless it presents as a metastatic disease [1]
We reported manifestations of distant metastases in the skull and proximal femur in a patient with silent follicular quality of life if the disease presents with distant organ metastasis
Differentiated thyroid cancers generally have an excellent prognosis and overall survival, 5–20% of patients develop distant metastasis during the follow-up which has a worse prognosis despite receiving sufficient treatment [3,7]
Summary
Follicular thyroid carcinoma is considered an indolent tumor with a favorable clinical outcome unless it presents as a metastatic disease [1]. Distant metastasis at diagnosis is detected in 3–10% of cases but usually will develop later as a disease progression in 6–20% of patients [2]. Delayed diagnosis in differentiated thyroid cancer might not affect long term survival, it can affect a patient’s. 2 of it diagnosis in differentiated thyroid cancer might not affect long term survival, can affect a patient’s quality of life if the disease presents with distant organ metastasis. We reported manifestations of distant metastases in the skull and proximal femur in a patient with silent follicular quality of life if the disease presents with distant organ metastasis. Distant metastases in the skull and proximal femur in a patient with silent follicular thyroid cancer
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