Low Back Pain as the First Presentation of Hürthle Cell Carcinoma of Thyroid

Abstract

H?rthle cell carcinoma is a rare variant of differentiated thyroid cancer and occasionally generates distant metastases. There are few reports of H?rthle cell carcinoma metastases to the vertebral column and none with sacral involvement. Here, we report a 48-year-old woman with a 2-year history of moderate low back pain, alleviated with analgesic medication. Her previous medical files were unremarkable. She performed medical evaluation, and a magnetic resonance of lumbar spine revealed a solitary hypointense T2 lesion on the left lamina of S1. The patient was submitted to percutaneous biopsy that displayed carcinomatous pattern compatible with H?rthle cell carcinoma of thyroid. After that, she was submitted to thyroid ultrasound that showed a nodule. Even in the presence of metastases, patients with H?rthle cell carcinoma usually have a relatively good prognosis. We discuss aspects of the diagnosis, management, and surgical treatment of metastatic H?rthle cell carcinoma in reference to the literature.