ETA2024 Poster Presentations Thyoid cancer case reports-2 (10 abstracts)
Epidural metastases revealing differentiated thyroid cancer: a case report
Oumaima Zitoun 1 , Rim Braham 1 , Med Wejdan Trabelsi 2 , Alia Methnani 3 , Mohamed Dhaha 3 , Souhail Jbali 3 , Sawsen Dhambri 4 & Skander Kdous 3
1Salah Azaiz Institute, Otorhinolaryngology Department, Tunis, Tunisia; 2Salah Azaiz Institute, Otorhinolaryngology Departement, Tunisia; 3Salah Azaiz Institute, Otorhinolaryngology Departement, Tunis, Tunisia; 4Salah Azaiz Institute, Ororhinolaryngoligy Departement, Tunis, Tunisia
Introduction: Follicular thyroid cancer (FTC) is the second most common type of differentiated thyroid cancer (DTC). It is more likely to metastasize to the bone compared to papillary types, primarily through blood spread. Bone involvement is seen in 6-12% of FTC cases, with the spinal column being the most affected area. However, spinal metastases most often appear in the late stages, making their presence as an initial revelation of the disease extremely rare.
Case report: A 58-year-old woman presented the neurosurgery department with complaints of low back pain and severe right leg pain and numbness for 6 months. Hypoesthesia was noted on the right S1 dermatome during physical examination. Computed tomography showed an osteolytic heterogeneous tumor involving the S1 vertebral body. The spinal MRI showed osteolytic lesions hypointense on T1-weighted images and heterogeneous hypo- and hyperintense on T2-weighted images with marrow replacement of the S1 vertebral body, extending into the epidural space. Lumbar biopsy was performed. Histopathological and immunohistochemistry studies confirmed the diagnosis of FTC. The patient underwent decompressive radiotherapy followed by total thyroidectomy and bilateral mediastinal-recurrent lymph node dissection. Pathological examination revealed follicular carcinoma. She was subsequently treated with iodine-131 ablation.
Conclusion: Spinal metastasis unveiling FTC is exceptionally uncommon. However, this diagnosis should be considered, particularly in cases where routine cancer screening fail to identify the primary tumor s site. Furthermore, imaging modalities for thyroid evaluation should be included in the diagnostic approach
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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