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Int J Surg Case Rep. 2017 Nov 28;41:498-501. doi: 10.1016/j.ijscr.2017.11.045. eCollection 2017.

Acute paraparesis as presentation of an occult follicular thyroid carcinoma: A case report.

International journal of surgery case reports

José Miguel Baião, Andreia Guimarães, Nídia Moreira, João Guardado Correia, Cristina Uriarte Rosenvinge, Diana Gonçalves, Mercedes Agundez Calvo

Affiliations

  1. General Surgery Department, Instituto Português de Oncologia de Coimbra Francisco Gentil E.P.E, Av. Bissaya Barreto 98, 3000-075 Coimbra, Portugal. Electronic address: [email protected].
  2. General Surgery Department (C), Centro Hospitalar e Universitário de Coimbra (Hospital Geral-Covões), S. Martinho de Bispo, 3041-853 Coimbra, Portugal. Electronic address: [email protected].
  3. General Surgery Department (C), Centro Hospitalar e Universitário de Coimbra (Hospital Geral-Covões), S. Martinho de Bispo, 3041-853 Coimbra, Portugal. Electronic address: [email protected].
  4. General Surgery Department, Instituto Português de Oncologia de Coimbra Francisco Gentil E.P.E, Av. Bissaya Barreto 98, 3000-075 Coimbra, Portugal. Electronic address: [email protected].
  5. General Surgery Department (C), Centro Hospitalar e Universitário de Coimbra (Hospital Geral-Covões), S. Martinho de Bispo, 3041-853 Coimbra, Portugal. Electronic address: [email protected].
  6. Internal Medicine Department (BB), Centro Hospitalar e Universitário de Coimbra (Hospital Geral-Covões), S. Martinho de Bispo, 3041-853 Coimbra, Portugal. Electronic address: [email protected].
  7. Internal Medicine Department (BB), Centro Hospitalar e Universitário de Coimbra (Hospital Geral-Covões), S. Martinho de Bispo, 3041-853 Coimbra, Portugal. Electronic address: [email protected].

PMID: 29546026 PMCID: PMC5723273 DOI: 10.1016/j.ijscr.2017.11.045

Abstract

INTRODUCTION: Follicular thyroid carcinoma is the second most frequent type of well differentiated thyroid tumours. It is usually confined to the thyroid gland, however it can metastasize in a later stage of the disease. Signs and symptoms associated with bone metastasis are rare as first clinical manifestations.

CASE REPORT: An 84-year-old female complained with acute paraparesis. Magnetic resonance imaging revealed an extensive intraosseous infiltrating lesion compatible with a bone metastasis from an occult tumour. Biopsy samples were compatible with bone metastasis from a follicular thyroid carcinoma. The patient was submitted to total thyroidectomy followed by iodine ablative therapy.

DISCUSSION: Follicular thyroid carcinoma presentation with symptoms related to bone metastasis is rare. Patients with bone lesions, such as pathological fractures or compressive symptoms should be studied since they may have clinically unapparent lesions from an unknown tumour. Patients with FTC should be submitted to total thyroidectomy. Bone lesions may be addressed to improve quality of life however this decision depends on disease extent.

CONCLUSION: Acute paraparesis is a rare form of presentation of thyroid carcinoma. These neoplasms must be taken into account when investigating metastasis to the bone from unknown neoplasms.

Keywords: Acute paraparesis; Bone metastasis; Case report; Follicular thyroid carcinoma

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