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Case Reports in Endocrinology
Volume 2013, Article ID 192573, 4 pages
http://dx.doi.org/10.1155/2013/192573
Case Report

Skeletal Muscle Metastasis as an Initial Presentation of Follicular Thyroid Carcinoma: A Case Report and a Review of the Literature

1Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh 59046, Saudi Arabia
2Histopathology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh 59046, Saudi Arabia
3King Saud bin AbdulAziz University for Health Sciences, Riyadh 11345, Saudi Arabia

Received 10 February 2013; Accepted 11 March 2013

Academic Editors: I. Broom, C. Capella, and K. Iida

Copyright © 2013 Mutahir A. Tunio et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Follicular thyroid carcinoma (FTC) frequently metastasizes to the lungs and bones. However, metastasis to the skeletal muscles is an extremely rare manifestation of FTC. To date, only seven cases of FTC have been reported in the literature. Skeletal muscle metastases from FTC usually remain asymptomatic or manifest as swelling and are associated with dismal prognosis. Case Presentation. A 45-year-old Saudi woman presented with right buttock swelling since 8 months. Physical examination revealed right gluteal mass of size  cm and right thyroid lobe nodule. The rest of examination was unremarkable. Magnetic resonance imaging (MRI) showed  cm lobulated mass arising from the gluteus medius muscle, and tru-cut biopsy confirmed the metastatic papillary carcinoma of thyroid origin. The patient subsequently underwent palliative radiotherapy followed by total thyroidectomy and radioactive iodine ablation. At the time of publication, the patient was alive with partial response in gluteal mass. Conclusion. Skeletal muscles metastases are a rare manifestation of FTC, and searching for the primary focus in a patient with skeletal muscle metastasis, thyroid cancer should be considered as differential diagnosis.