Follicular Thyroid Carcinoma Presenting as Large Solitary Vertebral Metastasis: Report of Two Unusual Cases Treated with Radiotherapy

Solitary spinal metastasis with cord compression as the presenting feature of follicular thyroid carcinoma (FTC) is extremely unusual with <10 cases reported in world literature. We hereby present two such cases in a 39-year-old male with lytic lesion left sacral bone with biopsy showing metastatic carcinoma with morphology and immunophenotype of thyroid gland and a 35-year-old female with thoracic vertebral lesions suggestive of metastatic deposit of FTC. Subsequently, both patients were found to have a solitary nodule in the thyroid lobe. They were treated with local radiotherapy (RT) with significant symptomatic relief. The present cases highlight the rarity of FTC to present as upfront solitary vertebral metastases with significant morbidity in young individuals although a slow indolent course with metastases in late stages of disease is more common, debilitating the effect of metastatic lesion requiring RT for pain palliation and the role of supportive nursing care for patient rehabilitation.