Pathological rib fracture as the first and only sign of occult follicular thyroid carcinoma: a rare case report

Recep Akgedik; Murat Karakahya; Şükran Akgedik; Şamil Günay; Ali Bekir Kurt

doi:10.5606/tgkdc.dergisi.2017.12667

Recep Akgedik¹, Murat Karakahya², Şükran Akgedik³, Şamil Günay⁴, Ali Bekir Kurt⁵

¹Departments of Chest Diseases, Medical Faculty of Ordu University, Ordu, Turkey
²Departments of General Surgery, Medical Faculty of Ordu University, Ordu, Turkey
³Departments of Pathology, Medical Faculty of Ordu University, Ordu, Turkey
⁴Department of Thoracic Surgery, Medical Faculty of Harran University, Şanlıurfa, Turkey
⁵Department of Radiology, Medical Faculty of Ordu University, Ordu, Turkey

DOI : 10.5606/tgkdc.dergisi.2017.12667

A 51-year-old man presented with pleuritic pain after hearing a breaking sound on the right side of his chest, while lifting a heavy weight. Physical examination revealed crepitation with mild swelling and tenderness over the fourth rib in the mid-axillary line. Thoracic computed tomography showed a mass in the right hemithorax lateral to the fourth rib, suggesting a malignant soft tissue tumor causing bone destruction and a pathological fracture. Since malignancy was reported in the intraoperative frozensection study, the lesion was removed with the third and fourth ribs. The result of the pathological examination was unexpectedly reported as a metastatic follicular thyroid carcinoma.

Keywords : Follicular thyroid carcinoma; metastasis; rib fracture

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