PT  - JOURNAL ARTICLE
AU  - Ashwini Mishra
AU  - Surya Kant
AU  - Anand Srivastava
AU  - Ajay Verma
AU  - Nuzhat Hussain
AU  - Rahul Kumar
AU  - Karthik Nagaraju
TI  - Intrathoracic mass as an initial presentation of follicular carcinoma of thyroid: A rare entity
AID  - 10.1183/13993003.congress-2015.PA3682
DP  - 2015 Sep 01
TA  - European Respiratory Journal
PG  - PA3682
VI  - 46
IP  - suppl 59
4099  - http://erj.ersjournals.com/content/46/suppl_59/PA3682.short
4100  - http://erj.ersjournals.com/content/46/suppl_59/PA3682.full
SO  - Eur Respir J2015 Sep 01; 46
AB  - Follicular carcinoma of thyroid is the second most common type of carcinoma of thyroid and it may metastasize to bone, lung, brain and skin. However, initial presentation of follicular carcinoma as a large intrathoracic mass without any symptoms of thyroid gland dysfunction is very rare and has not been reported to the best of our knowledge. We hereby report a case of a 40 year old male who presented with chief complaints of chest and low back pain. Preliminary evaluation was suggestive of provisional diagnosis of left sided intarathoracic mass with vertebral metastasis which was suspected to be a case of bronchogenic carcinoma with distant metastasis. Surprisingly, transthoracic biopsy and histopathology revealed metastasis from follicular carcinoma of thyroid. This prompted us for a retrograde evaluation for a primary thyroid malignancy for which an ultrasound and CECT of neck was done which confirmed the presence of a solitary thyroid nodule. USG guided fine needle aspiration cytology (FNAC) of the nodule revealed follicular carcinoma of thyroid. Histopathological evaluation subsequent to total thyroidiectomy revealed follicular carcinoma thyroid, confirming the diagnosis. The patient was then referred to the department of nuclear medicine and radiotherapy for radionuclide ablation and chemotherapy. We chose to report this case because of its rare presentation as a large intarathoracic mass and the retrograde diagnosis of follicular carcinoma of thyroid. This is the first report to best of our knowledge of this type of follicular carcinoma of thyroid presenting without any symptoms of thyroid dysfunction.