title: Cervical Cord Compression as Initial Presentation of Papillary Thyroid Carcinoma: a Case Report.
abstract: Cervical cord compression secondary to extension of a long standing papillary thyroid carcinoma as well as multiple cases of distal cord compression from occult follicular thyroid carcinoma have been reported. But cervical cord compression from Papillary Thyroid Carcinoma has not been reported so far. Forty eight year old lady presented with progressive quadriparesis of 2 months duration. MRI of the cervical spine showed destructive lesion with soft tissue component in vertebral bodies and posterior elements of C4-C6 vertebrae with cord compression along with a large thyroid mass extending to retrosternal region likely malignant. USG guided FNAC & Biopsy of thyroid lesion was inconclusive. She underwent Preoperative Selective angioembolisation for vertebral metastasis followed by total thyroidectomy with cervical cord decompression, bone grafting and plating. HPE reported follicular variant of Papillary Thyroid carcinoma. Four weeks postoperatively she underwent radioiodine ablation by 263 mci of I 131. She then received palliative EBRT to cervical and dorsal spine 30 Gy/10 fractions. She is alive and neurologically stable at 6 months follow up. Papillary thyroid carcinoma has an excellent prognosis. Hence a prompt management of primary disease and aggressive approach to metastatic lesion may prolong survival and allow favorable prognosis.
authors.affiliation: Department of Surgical Oncology, Rajiv Gandhi Cancer Institute & Research Centre, Delhi, 110085 India.
authors.forename: Veda Padma Priya
authors.initials: VP
authors.lastname: Selvakumar
authors.affiliation: Department of Surgical Oncology, Rajiv Gandhi Cancer Institute & Research Centre, Delhi, 110085 India.
authors.forename: Ashish
authors.initials: A
authors.lastname: Goel
authors.affiliation: Department of Surgical Oncology, Rajiv Gandhi Cancer Institute & Research Centre, Delhi, 110085 India.
authors.forename: Kapil
authors.initials: K
authors.lastname: Kumar
keywords: Malignant spinal cord compression; Metastatic ca thyroid; Spinal metastases; Vertebral metastases