title: Isolated Spinal Metastasis with Spinal Cord Compression Leads to a Diagnosis of a Follicular Thyroid Carcinoma.
abstract: BACKGROUND
  Thyroid carcinoma initially presents with clinical symptoms due to metastatic lesions in less than 5% of cases. Spinal cord compression from an epidural metastatic lesion as a first symptom is extremely rare. One would expect such a presentation to occur much later in the course of the disease.
  
  
  METHODS
  We are presenting a case report of a follicular thyroid carcinoma that presented with spinal cord compression from a thoracic epidural metastatic lesion in a previously healthy 55-year-old male. A single metastasis of follicular thyroid carcinoma presenting with posterior spinal cord compression is rare. In this particular case, our management included a mid-thoracic laminectomy, followed by resection of the epidural lesion. Once the surgical pathology confirmed the diagnosis of a follicular thyroid carcinoma, the general surgery team performed a near total thyroidectomy, after which he received radioactive iodine therapy. The patient is symptom-free at his three-year follow-up.
  
  
  CONCLUSIONS
  Initial presentation of follicular thyroid carcinoma with symptomatic thoracic myelopathy from an epidural metastasis is very uncommon. An early diagnosis and prompt surgical intervention provided an excellent outcome.
authors.affiliation: Neurosurgery, SUNY Upstate Medical University.
authors.forename: Gentian
authors.initials: G
authors.lastname: Toshkezi
authors.affiliation: Neurosurgery, SUNY Upstate Medical University.
authors.forename: Michael
authors.initials: M
authors.lastname: Galgano
authors.affiliation: Bachelor of Science, Temple University.
authors.forename: Silva
authors.initials: S
authors.lastname: Libohova
authors.affiliation: Orthopedic Spine Department, Syracuse Veteran's Affairs Hospital.
authors.forename: Satya
authors.initials: S
authors.lastname: Marawar
keywords: back pain; radioactive iodine ablation; spine metastasis; thyroid follicular carcinoma