Synchronous follicular carcinoma and non-invasive follicular thyroid neoplasm with papillary like nuclear features in thyroid-A case report

Abstract

Follicular carcinoma of the thyroid accounts for 5-15% of all the primary cancers of thyroid. Follicular carcinoma clinically manifests as a painless neck mass and rarely presents with metastatic bony lesion, the most common site being the spine. Non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) constitute 10-20% of all thyroid cancers. The histopathological diagnosis of thyroid follicular carcinoma mandates demonstration of either capsular/vascular invasion. Differentiating between follicular carcinoma and NIFTP is challenging based on histology. Hence extensive sampling of the pathological specimen is required to differentiate the same. Herein we report a case of an elderly woman presented with a pathological fracture of the femur due to metastasis from follicular carcinoma of the thyroid with an incidental NIFTP of the left lobe of the thyroid.