Unveiling follicular thyroid carcinoma by solitary spinal metastasis causing severe neurological deficit in a 67-year-old female: A case report.

[INTRODUCTION AND IMPORTANCE] Follicular thyroid carcinoma (FTC) exhibits the ability to metastasize hematogenously to distant organs. Spinal metastasis is an unusual site for metastasis that even when it does, spinal metastasis manifests late in the course of the disease and is frequently linked to advanced disease and a bad prognosis. Until 2019, the literature only showed 29 cases of FTC with spinal metastasis as the first presenting feature.

[CASE PRESENTATION] We present a case of a 67-year-old female who presented with an acute onset of severe neurological deficit that ended up bedridden. Magnetic resonance imaging of the spine revealed a spinal lesion causing severe spinal cord compression. Urgent surgical decompression was performed, and the histopathology confirmed metastatic FTC. Subsequent comprehensive evaluation, unveiled a primary thyroid tumor.

[CLINICAL DISCUSSION] FTC accounts for 1 % of all malignancies, Therefore, regardless of how irrelevant symptoms may appear at first, it is important to understand all risk factors, screening recommendations, diagnostic techniques, treatment, and the vast range of potential presenting symptoms. Just like our patient, who had incontinence and abrupt loss of motor and sensory function in her lower limbs to be diagnosed with spinal cord compression by metastatic FTC.

[CONCLUSION] This instance emphasizes how crucial it is to consider FTC as a possible differential diagnosis in cases with spinal metastasis, even when there is no known primary thyroid cancer. Prompt diagnosis, comprehensive staging, and multidisciplinary management are crucial in optimizing outcomes.