A Metastatic Follicular Thyroid Carcinoma to Clavicle and Sternum: A Case Report
Gemechu Abera Negasa, Nebiyou Simegnew Bayleyegn, Osias Tilahun Merga, Zenebe Teklu Gebremariyam, Samuel Tesfaye Woldemariam Department of Surgery, Faculty of Medicine, Institute of Health, Jimma University, Jimma, EthiopiaCorrespondence: Samuel Tesfaye Woldemariam, Department of Surgery, Faculty of...
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Dove Medical Press
2024-02-01
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| Series: | Open Access Surgery |
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| Online Access: | https://www.dovepress.com/a-metastatic-follicular-thyroid-carcinoma-to-clavicle-and-sternum-a-ca-peer-reviewed-fulltext-article-OAS |
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| author | Negasa GA Bayleyegn NS Merga OT Gebremariyam ZT Woldemariam ST |
| author_facet | Negasa GA Bayleyegn NS Merga OT Gebremariyam ZT Woldemariam ST |
| author_sort | Negasa GA |
| collection | DOAJ |
| description | Gemechu Abera Negasa, Nebiyou Simegnew Bayleyegn, Osias Tilahun Merga, Zenebe Teklu Gebremariyam, Samuel Tesfaye Woldemariam Department of Surgery, Faculty of Medicine, Institute of Health, Jimma University, Jimma, EthiopiaCorrespondence: Samuel Tesfaye Woldemariam, Department of Surgery, Faculty of Medicine, Institute of Health, Jimma University, Jimma, Ethiopia, Tel +251911554180, Email Docsam7770@gmail.comIntroduction: The incidence of thyroid cancer has increased in the last few decades, and follicular thyroid cancer (FTC) is the second most common differentiated thyroid cancer. Metastases outside the neck occur in 10% to 20% of patients with differentiated thyroid cancer and the most frequent locations are the lungs and bones.Case presentation: A 35 years old female patient presented with anterior neck swelling of 3 years duration and anterior chest swelling of 2 years duration. Objectively, there is a multilobulated 10 * 8 cm anterior neck mass, which is hard and moves with deglutition. She has 7*9 cm midline anterior chest mass, which is hard and also 3*3 cm hard mass on the medial end of the right clavicle. FNAC from the thyroid gland shows follicular carcinoma with the anterior chest mass of secondary deposits of similar malignant cells. Neck and chest CT scans were taken that showed enlargement of bilateral thyroid lobes showing internal flecks of calcifications with heterogeneously enhancing malignant sternal mass with lytic destruction of sternal cortex measuring 9*7*6 cm in widest dimensions and right medial clavicular mass, which is 2*3*2 cm with lytic destruction of the cortex. The patient was managed with total thyroidectomy + proximal clavicle resection + sternectomy + chest wall reconstruction. Postoperatively the patient stayed in the ward for 12 days and the course was uneventful, and both serum calcium and thyroid function tests were normal and discharged with levothyroxine.Conclusion: Patients with follicular thyroid carcinoma can present with multiple metastasis to flat bone at initial presentation. Individuals who present with resectable bony metastatic follicular thyroid cancer best be treated aggressively with thyroidectomy, resection of the bony metastasis and levothyroxine in a resource-limited setting were radio iodine ablation therapy is not available.Keywords: metastatic follicular carcinoma, clavicular metastasis, sternal metastasis, sternectomy, chest wall reconstruction |
| first_indexed | 2024-03-08T02:04:13Z |
| format | Article |
| id | doaj.art-d70cc325cfa342cdb2796617f9a63428 |
| institution | Directory Open Access Journal |
| issn | 1178-7082 |
| language | English |
| last_indexed | 2024-03-08T02:04:13Z |
| publishDate | 2024-02-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Open Access Surgery |
| spelling | doaj.art-d70cc325cfa342cdb2796617f9a634282024-02-13T19:43:10ZengDove Medical PressOpen Access Surgery1178-70822024-02-01Volume 17354190422A Metastatic Follicular Thyroid Carcinoma to Clavicle and Sternum: A Case ReportNegasa GABayleyegn NSMerga OTGebremariyam ZTWoldemariam STGemechu Abera Negasa, Nebiyou Simegnew Bayleyegn, Osias Tilahun Merga, Zenebe Teklu Gebremariyam, Samuel Tesfaye Woldemariam Department of Surgery, Faculty of Medicine, Institute of Health, Jimma University, Jimma, EthiopiaCorrespondence: Samuel Tesfaye Woldemariam, Department of Surgery, Faculty of Medicine, Institute of Health, Jimma University, Jimma, Ethiopia, Tel +251911554180, Email Docsam7770@gmail.comIntroduction: The incidence of thyroid cancer has increased in the last few decades, and follicular thyroid cancer (FTC) is the second most common differentiated thyroid cancer. Metastases outside the neck occur in 10% to 20% of patients with differentiated thyroid cancer and the most frequent locations are the lungs and bones.Case presentation: A 35 years old female patient presented with anterior neck swelling of 3 years duration and anterior chest swelling of 2 years duration. Objectively, there is a multilobulated 10 * 8 cm anterior neck mass, which is hard and moves with deglutition. She has 7*9 cm midline anterior chest mass, which is hard and also 3*3 cm hard mass on the medial end of the right clavicle. FNAC from the thyroid gland shows follicular carcinoma with the anterior chest mass of secondary deposits of similar malignant cells. Neck and chest CT scans were taken that showed enlargement of bilateral thyroid lobes showing internal flecks of calcifications with heterogeneously enhancing malignant sternal mass with lytic destruction of sternal cortex measuring 9*7*6 cm in widest dimensions and right medial clavicular mass, which is 2*3*2 cm with lytic destruction of the cortex. The patient was managed with total thyroidectomy + proximal clavicle resection + sternectomy + chest wall reconstruction. Postoperatively the patient stayed in the ward for 12 days and the course was uneventful, and both serum calcium and thyroid function tests were normal and discharged with levothyroxine.Conclusion: Patients with follicular thyroid carcinoma can present with multiple metastasis to flat bone at initial presentation. Individuals who present with resectable bony metastatic follicular thyroid cancer best be treated aggressively with thyroidectomy, resection of the bony metastasis and levothyroxine in a resource-limited setting were radio iodine ablation therapy is not available.Keywords: metastatic follicular carcinoma, clavicular metastasis, sternal metastasis, sternectomy, chest wall reconstructionhttps://www.dovepress.com/a-metastatic-follicular-thyroid-carcinoma-to-clavicle-and-sternum-a-ca-peer-reviewed-fulltext-article-OASmetastatic follicular carcinomaclavicular metastasissternal metastasissternectomychest wall reconstruction |
| spellingShingle | Negasa GA Bayleyegn NS Merga OT Gebremariyam ZT Woldemariam ST A Metastatic Follicular Thyroid Carcinoma to Clavicle and Sternum: A Case Report Open Access Surgery metastatic follicular carcinoma clavicular metastasis sternal metastasis sternectomy chest wall reconstruction |
| title | A Metastatic Follicular Thyroid Carcinoma to Clavicle and Sternum: A Case Report |
| title_full | A Metastatic Follicular Thyroid Carcinoma to Clavicle and Sternum: A Case Report |
| title_fullStr | A Metastatic Follicular Thyroid Carcinoma to Clavicle and Sternum: A Case Report |
| title_full_unstemmed | A Metastatic Follicular Thyroid Carcinoma to Clavicle and Sternum: A Case Report |
| title_short | A Metastatic Follicular Thyroid Carcinoma to Clavicle and Sternum: A Case Report |
| title_sort | metastatic follicular thyroid carcinoma to clavicle and sternum a case report |
| topic | metastatic follicular carcinoma clavicular metastasis sternal metastasis sternectomy chest wall reconstruction |
| url | https://www.dovepress.com/a-metastatic-follicular-thyroid-carcinoma-to-clavicle-and-sternum-a-ca-peer-reviewed-fulltext-article-OAS |
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