B. Letaief

Follicular thyroid carcinoma presenting as skull metastasis: A rare case report and literature review

Follicular thyroid carcinoma (FTC) is considered to be a well-differentiated thyroid carcinoma since it shows a low progression. Metastases occur in advanced stage by hematogenous route. Lung and bone are the two most common sites of metastases. In most of the reported cases of FTC metastasizing to the skull, metastases occurred long time after the diagnosis and establishment of adequate treatment for the primary cancer. Very few cases have been reported with FTC presenting as skull metastasis. We report the case of a 35-year-old female patient presented with a massive swelling of the right parietal skull region. Histopathologic examination confirmed that it is a FTC bone metastasis. A gross total resection of the tumor was performed. Two months later, a total thyroidectomy and lymph node resection were performed. The patient underwent radioactive-iodine (RAI) therapy and was given adjunctive Levothyroxine therapy. Five years of follow-up did not show any recurrence of the disease. Correct diagnosis of skull metastasis from preoperative FTC is difficult because of its rarity. Patients can survive several years after the therapy including total resection of metastatic tumor, radical operation of thyroid carcinoma, and adjunctive therapy by Levothyroxine and RAI therapy.