Cervical Cord Compression as Initial Presentation of Papillary Thyroid Carcinoma: a Case Report
- Resource Type
- Authors
- Ashish Goel; Kapil Kumar; Veda Padma Priya Selvakumar
- Source
- Subject
- medicine.medical_specialty
Cord
medicine.diagnostic_test
business.industry
medicine.medical_treatment
Soft tissue
Case Report
Cervical cord compression
Bone grafting
Occult
Surgery
Thyroid carcinoma
Lesion
03 medical and health sciences
0302 clinical medicine
Oncology
030220 oncology & carcinogenesis
Biopsy
Medicine
030212 general & internal medicine
Radiology
medicine.symptom
business
- Language
- English
Cervical cord compression secondary to extension of a long standing papillary thyroid carcinoma as well as multiple cases of distal cord compression from occult follicular thyroid carcinoma have been reported. But cervical cord compression from Papillary Thyroid Carcinoma has not been reported so far. Forty eight year old lady presented with progressive quadriparesis of 2 months duration. MRI of the cervical spine showed destructive lesion with soft tissue component in vertebral bodies and posterior elements of C4-C6 vertebrae with cord compression along with a large thyroid mass extending to retrosternal region likely malignant. USG guided FNAC & Biopsy of thyroid lesion was inconclusive. She underwent Preoperative Selective angioembolisation for vertebral metastasis followed by total thyroidectomy with cervical cord decompression, bone grafting and plating. HPE reported follicular variant of Papillary Thyroid carcinoma. Four weeks postoperatively she underwent radioiodine ablation by 263 mci of I 131. She then received palliative EBRT to cervical and dorsal spine 30 Gy/10 fractions. She is alive and neurologically stable at 6 months follow up. Papillary thyroid carcinoma has an excellent prognosis. Hence a prompt management of primary disease and aggressive approach to metastatic lesion may prolong survival and allow favorable prognosis.