alexa Thoracic Wall Metastasis from an Occult Thyroid Follicular Carcinoma
ISSN: 2167-7948

Journal of Thyroid Disorders & Therapy
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Case Report

Thoracic Wall Metastasis from an Occult Thyroid Follicular Carcinoma

Nadeesha Jeewan Nawarathna1*, Nawam R Kumarasinghe2, Deepthika Chandrasekara1, Rasika Shamalie Balasooriya3, Palitha Rathnayake4, Aruna A Shaminda2, Maujud M Rizmy1 and Ranjith JK Senevirathne5
1Registrar in Surgery, Teaching Hospital, Kandy, Mawanella, Sri Lanka
2Senior Registrar in Surgery, Teaching Hospital, Kandy, Mawanella, Sri Lanka
3University of peradeniya, Galaha Road, Peradeniya, Sri Lanka
4Consultant Pathologist, Teaching Hospital, Kandy, Mawanella, Sri Lanka
5Consultant Surgeon, Teaching Hospital, Kandy, Mawanella, Sri Lanka
Corresponding Author : Nadeesha Jeewan Nawarathna
MBBS, Teaching Hospital, Kandy
Mawanella, Sri Lanka
Tel: 94 812 222261
E-mail: [email protected]
Received Octomber 12 2014; Accepted December 22 2014; Published January 7 2015
Citation: Nawarathna N, Kumarasinghe NR, Chandrasekara D, Balasooriya R, Rathnayake P, et al. (2015) Thoracic Wall Metastasis from an Occult Thyroid Follicular Carcinoma. Thyroid Disorders Ther 4:168. doi:10.4172/2167-7948.1000168
Copyright: © 2015 Nawarathna NJ, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
 

Abstract

Occult thyroid carcinoma presenting with clinically apparent metastasis is rare and is a diagnostic challenge. Here we report a 68 year old male who presented with a left side chest wall mass of one year duration. The mass showed rapid enlargement at the latter end of its course, following an initial asymptomatic period. Imaging studies showed a soft tissue mass eroding into several ribs.Wide local excision with primary reconstruction was performed.Histological studies and immune staining revealed metastasis from a follicular thyroid carcinoma. Total thyroidectomy followed, confirming the diagnosis. Post-operatively radio isotope ablation (I131) was done.A suppression dose of thyroxin was continued with regular thyroglobulin assays. Painful bone responded well to analgesics, bisphosphonates and external beam radiotherapy. Follicular carcinoma comprise 10-15% of
thyroid malignancies. Localized thyroid carcinoma has a very good prognosis, ten year survival rates reducing by 50% with metastatic disease. Commonly thyroid cancer presents as detectable thyroid nodules, 25% having metastasis. In contrast metastatic manifestations are reported in less than 5% of occult thyroid cancers.

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