A Case of Metastatic Spinal Tumor in the Upper and Lower Thoracic Region Arising from Follicular Carcinoma of the Thyroid Gland

Jung, Sung Won; Cho, Bong Soo; Rhee, Dong Youl

Abstract

Among spinal tumors, the metastatic form is the most common form. This report describes a case of metastatic spinal tumor in the upper and lower thoracic region arising from follicular carcinoma of the thyroid gland. A 53-year-old female presented with a history of several months radiating pain in the right shoulder and arm. Magnetic resonance imaging showed bony expansion and a mass lesion of the first thoracic vertebra together with subtle cord compression. Using the anterior approach, the tumor was removed, and a bone graft was performed ; this was followed by radiation therapy. After discharge, the patient was followed up for 18 months, but was then readmitted due to right intercostal and midback pain. Plain X-ray and magnetic resonance imaging showed a destructive lesion of the right tenth rib and thoracic vertebra caused by an invasive tumor. Using the costotransversectomy approach, this was removed, and a bone graft was performed ; radiation and chemotherapy followed. The histological diagnosis was follicular carcinoma of the thyroid gland and the patient was discharged with no neurologic deficits. For neurologic recovery and the maintenance of stability, surgical treatment of a metastatic spinal tumor is thus necessary.