An Occult Follicular Thyroid Carcinoma Discovered 10 Years after the Metastasis

JOURNAL TITLE: Indian Journal of Endocrine Surgery and Research

Author
1. Sarada Khadka
ISSN
DOI
10.5005/jp-journals-10088-11157
Volume
16
Issue
1
Publishing Year
2021
Pages
3
Author Affiliations
    1. Department of Surgical Disciplines, All India Institute of Medical Sciences, Delhi, India
  • Article keywords
    Endocrine cancer, Endocrine surgery, Thyroid cancer

    Abstract

    The follicular thyroid carcinoma (FTC) may present with synchronous metastases. Rarely, the metastatic lesion is the only finding at the time of presentation (as in our case) leading to a diagnostic dilemma. We report an occult metastatic FTC case of a 68-year-old man who underwent excision of a rib tumor 10 years back. The histopathology confirmed the metastatic thyroid carcinoma but clinicoradiological evaluation did not reveal any thyroid nodule. He did not undergo a total thyroidectomy at that time. Now, he presented with pulsatile scalp swelling for 6 months. On examination, he was found to have a solitary thyroid nodule also. Fine needle aspiration cytology from scalp swelling and thyroid nodule demonstrated thyroid cells and follicular neoplasm, respectively, establishing the diagnosis of metastatic follicular thyroid cancer. The radioactive iodine (RAI) is given after total thyroidectomy. Total thyroidectomy followed by RAI is indicated even in cases of occult metastatic follicular thyroid carcinoma.

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