Bone metastasis of a follicular thyroid carcinoma originated in a toxic multinodular goiter.

Follicular thyroid carcinoma is the second most common thyroid malignancy, accounting for 5–15% of such tumours [1]. Because physical examination does not differentiate between benign and malignant nodules, laboratory and cytological evaluation are usually warranted [2]. When evaluating a thyroid nodule measuring serum thyrotropin (TSH) level is one of the first steps taken. If the serum TSH level is normal or elevated, the patient should undergo fine needle aspiration (FNA). However, if the serum TSH level is subnormal, a radionuclide thyroid scan may be performed prior to FNA in order to determine whether the nodule is hyper-, iso-, or non-functioning [3]. Thyroid cancer generally presents as a single, cold thyroid nodule on a radionuclide scan. Thyroid cancer manifesting as a hot nodule is much less frequent, with a prevalence of 4–11% [4]. It is unusual for this neoplasm to present early in its course as a single metastasis in the spine [5]. We report a case of follicular thyroid carcinoma presenting as a spine metastasis which originated in a toxic multinodular goiter.