Follicular Thyroid Cancer: An Unusual Metastasis to the Right Atrium Case Report and Literature Review

Background: Follicular Thyroid Cancer (FTC) is one type of the group of Differentiated Thyroid Cancer (DTC). It constitutes about 10% of this group. DTC is a rare disease and it remains to have a favorable prognosis in comparison to other forms of malignancy, with diseasespecific death rates as low as 1.3%. FTC has different biological characteristics, so unlike the more common Papillary Type (PTC), FTC has the ability for haematogenous spread. Case review: A 54-year-old woman presented with a thyroid swelling (FTC) causing progressive respiratory obstructive symptom. The swelling was clinically huge with retrosternal extension. Computed Tomography (CT) revealed destruction of medial part of the clavicle and sternum. It also showed encasement of the major neck vessels with extension in the right atrium. Methods: After an Institutional Review Board approval was granted (IRB) information about the case was collected by direct interview and by medical file review. Conclusion: FTC can present in an aggressive form and spread widely to destroy bones and encase major vessels including the heart as in this case. Though the standard treatment of DTC is surgical, in some cases any surgery other than taking a generous biopsy might be hazardous and pre-operative radiotherapy might be the only viable option.