Fine-needle aspiration cytology of isolated skull nodule: Unfolding the clinical spectrum

• Main Authors: Prajwala Gupta, Minakshi Bhardwaj
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2016-01-01
• Series: Indian Journal of Pathology and Microbiology
• Subjects: Disseminated; metastasis; minimally invasive follicular thyroid carcinoma; thyroid
• Online Access: http://www.ijpmonline.org/article.asp?issn=0377-4929;year=2016;volume=59;issue=3;spage=401;epage=403;aulast=Gupta

Follicular thyroid carcinoma (FTC) has been classified as either minimally invasive or widely invasive carcinoma and shows a propensity for blood-borne metastasis. Most common sites of metastasis are lung and bone followed by brain, liver, and skin. Minimally invasive FTC (MIFTC) is characterized by limited capsular and/or vascular invasion with good long-term outcomes, some cases of which show a poor prognosis because of severe distant metastasis. Skull metastasis in adults commonly arises from the lung, breast, and prostate and uncommonly from the thyroid. In our case, fine-needle aspiration cytology of isolated skull nodule was a reliable tool in the diagnosis of metastasis and suggesting the primary in thyroid thereby prompting early workup of a patient. The case is unique since it represents the rare disseminated metastasis from MIFTC with incomplete capsular penetration alone without angioinvasion that can behave as aggressively as a widely invasive FTC.