Lytic skull metastasis secondary to thyroid carcinoma in an adolescent.
We report an unusual case of skull metastasis secondary to thyroid carcinoma in an adolescent girl. The 18-year-old presented with an occipital scalp swelling of 5 years' duration. She reported having thyroid surgery in mainland China 10 years previously. Radiological investigations on presentation demonstrated a lytic hypervascular skull lesion. Preoperative angiography and embolisation was followed by surgical excision. Pathological examination showed the lesion to be a thyroid carcinoma with a predominantly follicular pattern and a completion hemithyroidectomy was subsequently performed. Computed tomography of the thorax showed small micronodules in both lung fields compatible with metastases. The patient was given whole body iodine-131 internal radiation treatment and subsequently commenced thyroid-stimulating hormone-suppressive treatment with thyroxine. The management of thyroid carcinoma and subsequent skull metastasis in children and adolescents is reviewed and controversial points are highlighted.
Wong
G K C
GK
Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
Boet
R
R
Poon
W S
WS
Ng
H K
HK
D018263:Adenocarcinoma, Follicular / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D000293:Adolescent; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D012888:Skull Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D013965:Thyroidectomy; D014916:Whole-Body Irradiation