Thyroid carcinoma with isolated spinal metastasis: case history and review of the literature

An unusual case of metastatic follicular thyroid cancer presenting with symptoms of a radiculopathy at C6 is presented. The patient underwent a laminectomy and removal of tumor with resolution of his symptoms. He was found to have a well differentiated follicular thyroid carcinoma and subsequently had total thyroidectomy and I-131 treatment. This patient's presentation raised questions about appropriate preoperative evaluation in this clinical scenario. This case highlights the importance of a thorough pre-operative work up for metastatic spine tumors. This should include evaluation of the thyroid consisting of thorough clinical history with particular attention to prior radiation exposure. Palpation of the thyroid also should be included as part of a routine pre-operative physical in cases of metastatic lesions of unknown origin. Thyroid function studies should not be utilized unless a clinical suspicion for thyroid cancer is raised during the examination. (C) 1999 Elsevier Science B.V. All rights reserved.