title: Unusual presentation of follicular carcinoma thyroid with special emphasis on their management.
abstract: BACKGROUND
  Follicular carcinoma of thyroid usually behaves in an indolent manner with low metastatic potential. Distant metastases as initial presentation is rare in follicular carcinoma; especially in young patients.
  
  
  METHODS
  We report the clinical, pathological features and the management of three different cases of follicular carcinoma of the thyroid with unusual presentations at the time of diagnosis. First case presented as thyroid abscess, second case with a large skull swelling in a pre-exiting goiter and the third case with a swelling in the sternum.
  
  
  CONCLUSIONS
  Follicular carcinoma of thyroid is the second category of well-differentiated thyroid cancer that constitutes about 10% of all thyroid malignancies. Blood borne metastasis is common with spread to lung, bone and other solid organs. In less than 10% cases of follicular carcinoma, there is evidence of lymphatic involvement. The patients' presentations above are highly unusual.
  
  
  CONCLUSIONS
  Recognizing these cases has a significant impact on clinical decision-making and prognosis of the patients. Treatment in these patients should be individualized and an alternative therapeutic approach should be considered.
authors.affiliation: Department of General Surgery, SCB Medical College, Cuttack, Odisha 753003, India. Electronic address: drsangram83@gmail.com.
authors.forename: Sangram Keshari
authors.initials: SK
authors.lastname: Panda
authors.affiliation: Department of General Surgery, SCB Medical College, Cuttack 753003, India.
authors.forename: Byomokesh
authors.initials: B
authors.lastname: Patro
authors.affiliation: Department of General Surgery, SCB Medical College, Cuttack 753003, India.
authors.forename: Manas Ranjan
authors.initials: MR
authors.lastname: Samantaroy
authors.affiliation: Department of General Surgery, SCB Medical College, Cuttack 753003, India. Electronic address: drjnms@gmail.com.
authors.forename: Jagadananda
authors.initials: J
authors.lastname: Mishra
authors.affiliation: Department of General Surgery, SCB Medical College, Cuttack 753003, India.
authors.forename: K C
authors.initials: KC
authors.lastname: Mohapatra
authors.affiliation: Department of General Surgery, SCB Medical College, Cuttack 753003, India.
authors.forename: R K
authors.initials: RK
authors.lastname: Meher