A rare case of follicular thyroid carcinoma metastasis to the sacral region: A case report with literature review

Abstract

Introduction

Follicular thyroid carcinoma (FTC) is the second most common thyroid cancer subtype after papillary thyroid cancer (PTC), and it accounts for approximately 10% of all thyroid cancers, the incidence of distant metastasis in FTC has been reported to be 6–20%, bones and lungs are the most frequent sites of distant metastases. Most occult thyroid carcinomas are papillary carcinoma.

Case presentation

We describe an extremely rare case of a 74-year-old woman who had a history of right thyroid lobectomy 20 years ago, was referred to our hospital for metastatic thyroid follicular carcinoma to the sacral region confirmed by the biopsy of the sacral mass. The patient was treated by analgesic radiotherapy, surgical totalisation of thyroidectomy, and Radioactive Iodine, with thyroid replacement by levothyroxine. In the follow up we noticed a significant symptom reduction leading to a much better quality of life.

Conclusion

Increasing importance should be given to rare metastases in DTP patients. Early detection will help in the early diagnosis and treatment of the disease, thereby improving the patient's survival rate and quality of life.

Highlights

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  Follicular thyroid metastasizes in a hematogenous way

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  It can lead to seriously sequelae if not diagnosed and treated early.

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  Not all bone metastases can be managed surgically depending on the location and the postoperative outcome.

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  RAI therapy I, without doubt is the most effective treatment in metastasized DTC, with limited side effects.