PMC4735619_01
A soft tissue density enhancing expansile lytic lesion involving the spinous process of the L5 vertebra
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F1
Due to the neurological status, an urgent CT-scan of the lumbosacral spine with contrast was carried out, which showed a soft tissue density enhancing expansile lytic lesion (55x44 mm) involving the spinous process of the L5 vertebra that was causing almost complete erosion of the spinous process and part of the lamina of the L5 vertebra (Fig.1).
Low power magnificationx10; Follicular carcinoma showing multiple variable colloid filled thyroid follicles infiltrating into the darkly stained bony trabeculae (Lumbar specimen
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F2
Final histopathology revealed a metastatic carcinoma most likely of thyroidal origin as the specimen showed thyroid follicles and was positive for the immunohistochemical marker, Thyroid transcription factor 1 (TTF1) (Figs.2,3). 
A 4.3 X 3 cm heterogeneously enhancing nodule is identified in the left lobe of the thyroid. An expansile lytic lesion involving the left third rib posterolaterally. is associated with an enhancing partly necrotic soft tissue component abutting the pleura and measuring 5 X 4 cm
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F4
It measured 4.3 X 3 cm and another expansile lytic lesion involving the left third rib posterolaterally was also seen measuring 5 X 4 cm (Fig.4).
Low power magnificationx10; Follicular carcinoma showing multiple variable colloid filled thyroid follicles infiltrating into the darkly stained bony trabeculae (rib specimen
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PMC4735619_01_ijo-28-067-g005.jpg
F5
Final histopathology revealed a follicular carcinoma in the left thyroid and metastatic follicular carcinoma in the 3rd rib mass (Fig.5).