Follicular Thyroid Carcinoma Presenting as a Humeral Mass: A Rare Case Presentation
Follicular thyroid carcinoma is the second most common cancer of the thyroid, which usually presents as a solitary thyroid nodule. Diagnosis of follicular thyroid cancer involving the appendicular skeleton is very rare. In this paper, we report a case of a 65-year-old woman who previously underwent...
Main Authors: | , , |
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Format: | Article |
Language: | English |
Published: |
Thieme Medical Publishers, Inc.
2020-08-01
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Series: | Asian Journal of Oncology |
Subjects: | |
Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1715763 |
Summary: | Follicular thyroid carcinoma is the second most common cancer of the thyroid, which usually presents as a solitary thyroid nodule. Diagnosis of follicular thyroid cancer involving the appendicular skeleton is very rare. In this paper, we report a case of a 65-year-old woman who previously underwent partial lobectomy of the left thyroid gland, and who consequently presented with a 2-year history of gradually enlarging left arm mass. Initial whole-body bone imaging revealed a large osteolytic lesion in the humerus. An MRI (magnetic resonance imaging) of the left arm showed a heterogeneously enhancing, encapsulated, soft tissue mass with humeral involvement, and the initial impression was osteosarcoma versus fibrosarcoma. Biopsy reading of the humeral mass was morphologically compatible with a well-differentiated metastatic thyroid carcinoma. She subsequently underwent right lobectomy where histopathology showed Hashimoto’s thyroiditis. A slide review was requested and the biopsy of the humeral mass revealed adenocarcinoma with follicular architecture, compatible with a metastatic thyroid carcinoma. Meanwhile, the findings on the right thyroid lobe revealed a multinodular colloid adenomatous goiter with hyperplastic features in a background of Hashimoto’s thyroiditis. This report demonstrated a rare presentation of follicular thyroid carcinoma metastasizing to the humerus that can be confused with primary bone tumors, both clinically and radiologically. Early diagnosis and a high index of suspicion is foremost for immediate and appropriate management. |
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ISSN: | 2454-6798 2455-4618 |