PMC6136467_01
Retrospective assessment of the preoperative plain radiographs of the left foot shows a 3 cm oval lytic lesion in the anterior aspect of the calcaneum.
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fig1
MRI of the left ankle: T2-WI with fat saturation sequences obtained in the coronal and sagittal planes confirm the presence of anterior calcaneal bone tumor (white arrows).
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fig2
(a) Calcaneus: calcaneus lesion showing neoplastic thyroid follicular cells (H&E, x200). (b) Thyroglobulin: neoplastic cells in the calcaneus lesion expressing thyroglobulin (thyroglobulin immunostains, x200).
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fig3
Immunostaining showed that the cells expressed cytokeratin, cytokeratin 7, and thyroglobulin, all of which confirm the diagnosis (Figure 3).
Thyroid: original follicular carcinoma in the thyroid (H&E, x200).
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fig4
Postoperative plain radiographs and MRI (sagittal T1-WI and T2 fat sat sequences) reveal postsurgical changes in the calcaneus with decrease in the size of the mass which is partially replaced with marrow fat.
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fig5
A left ankle X-ray and MRI were ordered (Figure 5) to rule out any recurrence at the surgical site.
X-ray of the right knee reveals a mixed sclerotic and lytic lesion in the proximal aspect of the tibia with anterior cortical disruption.
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fig6
Surgical resection of the metastasis with repair of the patellar tendon was performed, and pathology was also consistent with thyroid follicular cell carcinoma (Figures 6 and 7).
MRI of the right knee: sagittal T1-WI and T2-WI sequences of the knee show a 4.5 cm lytic expansile mass at the anterior proximal aspect of the tibia involving the patellar tendon insertion. A sclerotic area is seen along the posterior border.
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fig7
Surgical resection of the metastasis with repair of the patellar tendon was performed, and pathology was also consistent with thyroid follicular cell carcinoma (Figures 6 and 7).