Solitary vertebral column metastasis from occult sclerosing carcinoma of the thyroid gland: report of a case.

Patchefsky, Arthur S., Keller, I. B., and Mansfield, Carl M.: Solitary vertebral column metastasis from occult sclerosing carcinoma of the thyroid gland. Report of a case. Airier. J. Clin. Path. 53: 596-601, 1970. The case of a 54-yearold man with carcinoma of the thyroid gland metastatic to the vertebral column is reported. Serial sectioning following total thyroidectomy revealed a 0.85-mm., occult, sclerosing carcinoma and a 3-mm. Hurthle-cell adenoma. The literature is reviewed; no previous case of a minute, occult, sclerosing carcinoma of the thyroid gland presenting as a blood-borne metastasis has been found. I T IS WELL ESTABLISHED that small, nonpalpable thyroid cancers can produce metastases. Hazard and Woolner and associates have shown that 23 and 43% of their cases of occult carcinoma, respectively, metastasized to cervical lymph nodes. Such metastases from thyroid carcinomas less than 1 mm. in diameter have been reported.14 The smallest of these primary tumors thus far have been 0.6 mm. and 0.7 mm. in diameter. Occult thyroid carcinomas manifest primarily as blood-borne metastases without cervical lymph node involvement are rare. The finding of a 0.85mm. occult sclerosing carcinoma of the thyroid gland presenting as a solitary vertebral column metastasis is the subject of this case report.