Publication:

Thyroid papillary carcinoma presenting with femoral neck metastasis: a case report

Thyroid carcinoma is relatively uncommon, accounting for 2% of all cancers. Although they usually present as a neck lump, occasionally they may be presented with a distant metastasis. In this study, a 65 year-old woman was referred to our clinic with a pain on her left hip at both rest and walking. A lytic area at the inferior femoral neck was found with plain radiography. To clarify the characteristics of the lesion, left hip magnetic resonance imaging (MRI) had been performed displaying 3×5 cm hyperintense lesion extending from medial part of the left femoral neck to the left femoral head. Laboratory findings were normal. An open biopsy had then been performed from the left femoral neck with a suspicion of a metastatic tumor. After Immunohistochemical assesment diagnosis was consistent with metastatic thyroid papillary cancer. Proximal femoral resection with clear margins were achieved by proximal femur tumor endoprosthesis.  In conclusion, papillary thyroid cancer have an excellent prognosis and doesn’t tend to metastese. But rarely, as seen in our case it can even present with syptoms of metastasic disease. Management strategy is the same as other solitary bone metastasis. Papillary thyroid cancer must be kept in mind as a differential diagnosis in solitary bone metatasis.