Follicular Thyroid Carcinoma Presenting as Massive Skull and Super Cervical Vertebra Metastasis:Misdiagnosis A-nalysis
WANG Jian
PENG Hua
ZHANG Jin-he
WANG Wei
Abstract：Objective To investigate the features of occult follicular thyroid carcinoma (FTC) presenting as skull and super cervical vertebra metastasis in order to avoiding missed diagnosis and misdiagnosis. Methods A case of super cer-vical vertebra and occipital bone metastasis of FTC was reported and related literatures were reviewed. Results This female patient was 45 years old. She visited doctors many times for neck discomfort in the past two years before admission to this hos-pital. During that time she was usually treated with physical therapy as cervical syndrome. Her neck discomfort became more and more serious in the past six months, while a mass was felt in her left neck. Soon after, ultrasonography examination showed that there was a solid lesion in the neck under left ear. Meanwhile, her CT scan showed that there was serious bone destruction with her super cervical vertebra and occipital bone. Then she was hospitalized with the diagnosis of neck lump in our department. It was reported as multiple nodes in her thyroid by ultrasonography, which indicated diagnosis of nodular goi-ter ( suspected as nasopharyngeal carcinoma and leucoma) . Surgical pathology of neck mass indicated that it was a metastatic adenocarcinoma. 18 F-FDG PET-CT showed that there was a hypermetabolic node in the left lobe of thyroid ( suspected as thy-roid carcinoma) . Finally the patient underwent total thyroidectomy and microscopic examination confirmed the FTC diagnosis. She had been followed up for 2 years after total thyroidectomy, during which 131 I and 125 I therapy were given and the patient's condition remains stable now. Conclusion Thyroid malignant tumor, especially FTC should not be considered when there is a concomitance of cervical vertebra and/or skull destruction and thyroid nodule to avoid missed diagnosis and misdiagnosis.
Keywords：Thyroid NeoplasmAdenocarcinomafollicularNeoplasm metastasisCervical vertebraeSkull baseMisdiagnosis
Publication Date：2014-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：3( 42-44 )