Concurrent Hip Pain and Skull Lump as the First Manifestations of a Silent Follicular Thyroid Carcinoma

Follicular thyroid carcinoma is a slowly growing cancer with a generally good long-term
prognosis. Distant metastasis from follicular thyroid cancer usually occurs in the lung and bones
following a long period after diagnosis and treatment for primary cancer. Occult skull metastasis as the
first presentation at diagnosis from follicular thyroid cancer is relatively rare. A 51-year-old woman
presented with intermittent pain in her right hip that was treated due to the intensely progressed
pain, motor weakness, and di�culty walking. The patient was then referred due to swelling in the
forehead. Further evaluation revealed that the frontal swelling and the pathological femoral fractures
were manifestations of distant metastases from follicular thyroid cancer. In the presence of swelling in
the skull, the metastatic lesion should be considered as a di�erential diagnosis from a silent primary
cancer. This report will be beneficial for general practitioners, surgeons, and internists to recognize
unusual distant metastatic manifestations from silent di�erentiated thyroid cancer.