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Japanese Journal of Clinical Oncology 30:27-29 (2000)
© 2000 Foundation for Promotion of Cancer Research

Follicular Thyroid Cancer Presenting Initially with Soft Tissue Metastasis

Alper Sevinc1, Suleyman Buyukberber1, Ramazan Sari1, Tamer Baysal2 and Bulent Mizrak3,+

Departments of 1Internal Medicine, 2Radiology and 3Pathology, School of Medicine, Turgut Ozal Medical Center, Inonu University, Malatya, Turkey

Follicular thyroid cancer rarely manifests itself as a distant metastatic lesion. We report a case of an otherwise asymptomatic 58-year-old woman with follicular thyroid cancer who initially presented with a soft tissue mass on the right scapular region. An incisional biopsy specimen of soft tissue metastasis showed thyroid follicular neoplasm. Upon this diagnosis, the thyroid gland was re-evaluated by ultrasound, which demonstrated a solitary, hypoechoic nodule in the right lobe. Ultrasonography guided fine-needle aspiration biopsy of the thyroid nodule confirmed follicular neoplasm and the diagnosis of metastatic follicular thyroid cancer was established. The patient refused any type of treatment and left hospital against medical advice. 2.5 years later the patient was admitted to the hospital with giant, sarcoma-like multiple soft tissue masses. On this admission, the serum thyroglobulin level was extremely elevated (3500 ng/ml) and she only accepted to receive chemotherapy. Epirubicin and cyclophosphamide were administered. She received three courses of chemotherapy and is alive with a stable disease after 3 months of follow-up. This case of follicular thyroid cancer is reported because of its uncommon initial presentation with soft tissue metastasis which spread to multiple areas as giant soft tissue masses during follow-up.

+ For reprints and all correspondence: Suleyman Buyukberber, Department of Internal Medicine, School of Medicine, Turgut Ozal Medical Center, Inonu University, 44069 Malatya, Turkey. E-mail: sbuyukberber@usa.netAbbreviations: FTC, follicular thyroid cancer; TG, thyroglobulin; CT, computerized tomography; RI, radioactive iodine


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