PMC4318834_01
Metastatic follicular carcinoma to cranial bone.
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F0001
An immunohistochemical panel showed positive staining for CK7, thyroglobulin, and HBME-1 while it was weakly positive for pankeratin, suggesting a thyroid origin of these lesions, that is, metastatic FTC (Fig. 1).
CT head with and without contrast showing a large, round, relatively smoothly marginated enhancing extra-axial left frontal mass (4.4 cm in anteroposterior diameter and 4.1 cm in transverse diameter) that has eroded and partially destroyed the calvarium and extends into the subcutaneous scalp.
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F0002
On computed tomography (CT) of the head, two large extra-axial enhancing masses with both intra- and extracranial components were seen (Figs. 2, 3).
CT head with and without contrast demonstrating a large, round, relatively smoothly marginated enhancing extra-axial mass (measuring 6.8 cm in transverse diameter, 5.9 cm in AP diameter) involving the right and left parietal region, straddling the posterior falx cerebri and superior sagittal sinus.
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F0003
On computed tomography (CT) of the head, two large extra-axial enhancing masses with both intra- and extracranial components were seen (Figs. 2, 3).
MRI brain revealing a large 7.1x3.8 cm fairly homogeneous enhancing relatively well-defined mass centered in the posterior calvarium with intracranial extension into the extra-axial space as well as extracranial extension. The mass abuts the superior sagittal sinus. There is a similar appearing 3.7x4.5 cm fairly homogeneous relatively well-defined enhancing mass centered in the left anterior lateral calvarium also extending into the extra-axial space as well as extracranially.
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F0004
Magnetic resonance imaging (MRI) of the brain demonstrated 7.1x3.8 cm and 3.7x4.5 cm fairly homogeneous, enhancing, relatively well-defined masses centered in the posterior and left anterior lateral calvarium with intracranial and extracranial extensions but without any vasogenic edema or mass effect on the brain (Fig. 4).
Total thyroidectomy specimen with follicular carcinoma.
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The patient underwent a total thyroidectomy (Fig. 5).
Follicular carcinoma of thyroid invading adjacent thyroid parenchyma.
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F0006
Histopathological studies of the thyroid gland revealed a well-differentiated FTC in the left lobe, pathological stage pT2NXM1, a 1-cm focus of classic papillary thyroid cancer in the right lobe of thyroid, with a background of multinodular goiter (Fig. 6).