Multi-Organ Distant Metastases in Follicular Thyroid Cancer- Rare Case Report

Follicular thyroid carcinoma (FTC) usually behaves in an indolent manner with blood borne metastatic potential. The major sites of distant metastases are the lung and bone. Metastases to the liver, Lung, bone and skin together are rare or relatively rare. These metastases have almost always appeared in patients with advanced disease and are often associated with poor prognosis but overlooked in clinical practice. Recognizing them has a significant impact on clinical decision-making and prognosis of the patients. Here, we are reporting the clinical details of an elderly lady who presented with a swelling in the skull of 2 month duration, left iliac bone swelling since 3 months. She had an otherwise asymptomatic thyroid swelling of 30 years duration also. Radiology revealed a lytic lesion on the iliac bone, vertebrae, ribs and liver and lung metastasis. Cytological confirmation was done to diagnose follicular cancer of thyroid with scalp and iliac bone metastasis. Surgical resection is still the first choice for the primary and followed by radioiodine therapy for metastatic sites.