Follicular thyroid carcinoma with intramedullary spinal cord metastasis: case-report

Abstract

Metastatic carcinomas are more prevalent in the vertebrae and epidural spaces than in the intradural and intramedullary spinal cord. Although thyroid carcinomas seldom induce intramedullary spinal cord metastases, no evidence has been presented to prove that pure follicular thyroid carcinomas can generate these metastases. In this case, a man in his late 30s who had undergone lymphadenectomy, thyroidectomy, and radioactive iodine therapy developed spastic paraparesis and urine retention. Owing to the patient's aggressive clinical presentation with intramedullary metastasis, an initial tumor biopsy was performed to determine the histology of the tumor. Following an unexpectedly negative first biopsy, the patient underwent thorough tumor excision, the histopathology of which revealed a metastatic pure thyroid follicular carcinoma. Hence, it is imperative that all patients with pure follicular thyroid cancer who have developed acute neurological symptoms, regardless of how long they have been in remission, be immediately evaluated for intramedullary spinal cord metastases.