Klin Onkol 2019; 32(4): 300-302. DOI: 10.14735/amko2019300.
Introduction: Bone metastasis is seen in 2.3–12.7% of thyroid follicular carcinomas. Bone metastasis most commonly occurs in the vertebrae, costas and hip bones. In this report we discuss the diagnosis and treatment of a patient followed up due to skull metastasis of thyroid follicular carcinoma in light of literature. Case report: A 51-year-old female patient underwent surgery due a mass in the scalp. The histopathological examination was reported as metastasis of follicular thyroid carcinoma. No radiotherapy was indicated because of the total excision of the mass and the benign surgical margins. The patient, in whom fine needle aspiration biopsy showed the result of follicular carcinoma underwent a total bilateral thyroidectomy. Whole-body I-131 scintigraphy revealed diffuse activity involvement in the thyroid gland, and lung and bone (skull, sacrum, right acetabulum) metastasis. The patient was scheduled for radioactive iodine therapy. Conclusion: Total/near total thyroidectomy and metastasectomy should be the treatment of choice in skull metastasis. Postoperative radioactive iodine and radiotherapy should be offered. Radiotherapy should be reserved for inoperable and residual tumour cases.
