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KMID : 0942820100090010039
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Journal of Korean Brain Tumor Society
2010 Volume.9 No. 1 p.39 ~ p.43
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A Case of Unusual Metastatic Skull Tumor from Follicular Thyroid Carcinoma of Skull Presenting Rapid Progressive Neurologic Symptom
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Lee Seung-Eun
Park Seung-Won
Nam Taek-Kyun
Hwang Sung-Nam
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Abstract
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Metastatic skull tumors from thyroid carcinoma to the skull are known to be very rare. Although well-differentiated primary thyroid carcinomas are slow-growing tumors with a good prognosis, the development of skull metastasis can result in poor prognosis.A 67-year-old woman presented with a palpable mass in the right anterior neck and general weakness in the department of general surgery. She underwent ultrasound-guided fine needle aspiration biopsy and was diagnosed with follicular thyroid carcinoma(FTC). During preparing for thyroidectomy, she complained of right leg weakness(grade IV), aggravated rapidly(grade III) within 24 hours. Brain computed tomography(CT) showed a strongly enhancing and osteolytic mass (8×3 cm) at left frontotemporal skull expanding to the middle cranial fossa, which compressed brain parenchyme with midline shift. Craniectomy, subtotal tumor removal, and cranioplasty with bone cement were performed. The tumor was yellowish white with gelatinous consistency, occupied the diploic space of cranial bone. During craniectomy, bone bleeding was profuse and hard to control with bone wax. Her right leg weakness disappeared immediately after the surgery. The histopathological diagnosis of the skull bone mass revealed as well-differentiated FTC. After 6 weeks of cranial surgery, total thyroidectomy, I131 radio-iodine therapy and tyroid replacement were done.
We report a rare case of skull metastasis from FTC, which has rapid progressive neurologic symptoms by mass effect and was successfully managed with subtotal tumor removal and subsequent radio-iodine therapy.
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KEYWORD
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Skull metastasis, Follicular thyroid carcinoma
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