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

An unusual case of metastatic follicular thyroid cancer presenting with sym ptoms of a radiculopathy at C6 is presented. The patient underwent a lamine ctomy and removal of tumor with resolution of his symptoms. He was found to have a well differentiated follicular thyroid carcinoma and subsequently h ad total thyroidectomy and I-131 treatment. This patient's presentation rai sed questions about appropriate preoperative evaluation in this clinical sc enario. This case highlights the importance of a thorough pre-operative wor k up for metastatic spine tumors. This should include evaluation of the thy roid consisting of thorough clinical history with particular attention to p rior radiation exposure. Palpation of the thyroid also should be included a s part of a routine pre-operative physical in cases of metastatic lesions o f 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.