Case Report
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World J Radiol. Jun 28, 2012; 4(6): 286-290
Published online Jun 28, 2012. doi: 10.4329/wjr.v4.i6.286
Skull metastasis in papillary carcinoma of thyroid: A case report
Akshay Nigam, Ajay K Singh, Sanjeev K Singh, Neelima Singh
Akshay Nigam, Department of Radiation Oncology, Gajra Raja Medical College and Jaya Arogya Group of Hospitals, Gwalior 474001, Madhya Pradesh, India
Ajay K Singh, Sanjeev K Singh, Neelima Singh, Department of Biochemistry, Gajra Raja Medical College and Jaya Arogya Group of Hospitals, Gwalior 474001, Madhya Pradesh, India
Author contributions: Nigam A study design radiological imaging and evaluation; Singh AK designed the study and wrote the paper; Singh SK helped in manuscript writing; Singh N contributed to manuscript proofreading and finalization of manuscript.
Correspondence to: Ajay K Singh, PhD, Department of Biochemistry, Gajra Raja Medical College and Jaya Arogya Group of Hospitals, Gwalior 474001, Madhya Pradesh, India. ajsingh25@gmail.com
Telephone: +91-90-39521365 Fax: +91-90-39521365
Received: December 22, 2011
Revised: April 4, 2012
Accepted: April 11, 2012
Published online: June 28, 2012
Abstract

Papillary thyroid carcinoma with metastasis to the skull is extremely rare. We report a case of unsuspected papillary thyroid carcinoma with skull metastasis. A 48-year-old female patient presenting with painless, pulsatile, progressively increasing swelling in the occipitoparietal region of the scalp approached for an X-ray of the skull. Ultrasound of palpable swelling in the neck revealed a heteroechoic lesion with increased vascularity. Foci of calcification were seen involving both lobes of the thyroid. Ultrasound of scalp showed a destructive mass in the skull with increased vascularity. Biopsy of thyroid lesions revealed branching papillae having a dense fibrovascular core covered by cuboidal epithelial cells with nuclei having a clear ground glass appearance. This case illustrates how isolated extensive skull metastasis can be found in papillary carcinoma patients without causing significant morbidity. Therefore, in the clinical course of thyroid papillary carcinoma, skull metastasis should be considered, and the patients should be meticulously investigated and followed up.

Keywords: Papillary thyroid carcinoma; Skull metastasis; Biopsy