METASTASIS IN THE COSTAL WALL AS A PRESENTATION OF PAPILLARY THYROID CARCINOMA

AUTHORS:
D. Morales (MALAGA, Spain) , J.L. Fernandez (MALAGA, Spain) , S. Rocio (MALAGA, Spain) , P. Guillermo (MALAGA, Spain) , M.D. Dominguez (MALAGA, Spain) , L. Perez (MALAGA, Spain) , J. Garcia (MALAGA, Spain) , L.T. Ocaña (MALAGA, Spain)
Background:
The case of a patient with a metastasis in the right costal wall as a presentation of papillary thyroid cancer is reported.
Methods:
A 66-year-old men presented with pain and a mass in the right costal wall, independent of the thyroid. Right thyroid PAFF was performed with result of BETHESDA IV and BAG results of the mass reported as metastasis of papillary thyroid cancer. Ultrasound images and CT scan (iconography) confirm the existence of a mass affecting the costal wall independent of the thyroid, and an enlarged thyroid gland.
Results:
A total thyroidectomy and partial sternal with 1st and 2nd rib resection were performed, repairing the defect with a Tryomix plate (iconography). The pathological study reports papillary carcinoma with a follicular pattern measuring 9.8 cm on the right side and colloid nodules on the left, with vascular and perineural invasion and metastasis by papillary thyroid cancer in a costal wall resection piece. Uneventful postoperative evolution
Conclusions:
Bone metastases in thyroid cancer can appear in up to 25% of cases and almost half of them are diagnosed synchronously with the primary tumor. Surgery, if possible, is the initial treatment of choice in these patients