Follicular carcinoma thyroid presenting as skull metastasis: a rare case report


  • Manju P. Antony Department of General Surgery, Government Medical College, Ernakulam, Kerala, India
  • Meer M. Chisthi Department of General Surgery, Government Medical College, Trivandrum, Kerala, India
  • Tessy P. Joseph Department of Pathology, Government Medical College, Ernakulam, Kerala, India



Differentiated thyroid cancer, Follicular thyroid cancer, Metastasis, Osteolytic


Follicular cancer is the second commonest form of differentiated thyroid malignancy. Unlike papillary cancer which has a predilection for lymph node metastases, it spreads more often by the hematological route. Even when they have spread to various organs, differentiated thyroid cancers have excellent prognosis if they can be resected completely. One of the presentation of metastases from follicular cancer is with pulsatile skull metastases. Here, we are reporting the clinical details of an elderly lady who presented with a swelling in the skull of 1 month duration. She had an otherwise asymptomatic thyroid swelling of 18 years duration also. Radiology revealed a lytic lesion on the skull. Cytological confirmation was done to diagnose follicular cancer with skull bone metastasis. After total thyroidectomy surgery, she was sent for radio-active iodine ablation and levothyroxine suppression. We are presenting this case as it is not a common form of presentation of this disease.


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