Unusual Clinical Course of Papillary Thyroid Microcarcinoma: Metastases of Bone and Lung

Papillary thyroid microcarcinomas are slow-growing tumours; distant metastases causing mortality is very rare. Case presentation We report the case of a 35-year-old woman with lung and bone metastases of a multifocal papillary thyroid microcarcinoma (PTMC). She had undergone a subtotal thyroidectomy due to euthyroide multinodular goitre without fine needlle aspiration biopsy. Iodine-131-whole body scan showed markedly iodine retention in the neck, lung and pelvis. Chest computed tomography (CT) and Pelvic magnetic resonance imaging (MRI) confirmed metastases in the lung and ischium pubis. She underwent completion thyroidectomy and bilateral neck dissection. She is going to have high dose radioactive iodine ablation therapy after resection of bone metastases. Conclusion: It should be considered that patients with papillary microcancer can rarely show agressive clinic.