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Metastatic Occult Follicular Thyroid Carcinoma

Timothy Boehm, MD, MC; Lloyd Rothouse, MD; Leonard Wartofsky, MD
JAMA. 1976;235(22):2420-2421. doi:10.1001/jama.1976.03260480040033.
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FOLLICULAR carcinoma of the thyroid with distant metastases is considered a relatively progressive tumor associated with a poor five-year survival rate1-3 and is rare in the absence of any abnormality in the neck by palpation or scan.4 The following case illustrates two unusual features: (1) slow growth of a solitary metastasis from follicular carcinoma (2) distant metastasis from a small focus of follicular carcinoma that could not be detected by palpation or isotopic scanning of the thyroid.

Report of a Case  A 28-year-old woman was initially seen in October 1974, with a one-year history of left occipital headaches, which had increased in frequency over the previous three months. A skull roentgenogram (Fig 1) showed a 16-mm diameter lytic lesion of the left occiput. In December 1972, she had been beaten during a family quarrel and was taken to a local hospital. Skull roentgenograms (Fig 1) obtained from this


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