Follicular carcinoma of the thyroid with a single metastatic lesion in the lumbar spine: A case report

Figure 1 Computed tomography images obtained before surgery. The posterior mass at the L4 was considered to be a metastatic tumor with secondary spinal stenosis. A and B: Sagittal view of the lumbar spine; C and D: Magnification of the sagittal plane; E: Horizontal view of the lumbar spine.

Figure 2 Magnetic resonance imaging images obtained before surgery. The lesion at the L4 vertebra and left adnexa was considered a malignant tumor. Spinal canal stenosis at the L4/5 disc level was observed. A and B: Sagittal view of the lumbar spine; C and D: Horizontal view of the lumbar spine.

Figure 3 Positron emission tomography-computed tomography images obtained before surgery. There was L4 vertebral expansionary osteolytic bone destruction accompanied by increased uneven metabolism. A: Mild intake of fluorodeoxyglucose; B: Coronal view of the lumbar spine; C: Horizontal view of the lumbar spine; D: Sagittal view of the lumbar spine.

Figure 4 L4 vertebral body surgery. A: Complete removal of the L4 vertebrae; B: Replacement and fixation of artificial vertebral body.

Figure 5 Routine postoperative radiography. A: Anteroposterior lumbar vertebrae; B. Lateral lumbar vertebrae.

Figure 6 Postoperative pathology of the L4 pyramids. The thyroid follicular structure was observed in the bone and bone marrow tissue, and thyroid cancer metastasis was considered. A: Gross specimen of the L4 vertebra; B and C: Follicular structure (40 × and 100 ×; hematoxylin and eosin); D: Immunohistochemistry indicated that the tumor was positive for galectin-3.

Figure 7 Pathological analysis of the right nodular goiter with partial adenomatous hyperplasia, left nodular goiter with partial atypical adenomatous hyperplasia nodules and isthmus nodular goiter. A: Follicular structure [20 ×; hematoxylin and eosin (HE)]; B: Pathological mitosis (40 ×; HE).