Isolated solitary recurrent skull metastasis in papillary thyroid carcinoma

Description  

A 38-year-old woman presented with history of painless expansible swelling in the right frontoparietal region since 2 years and rapidly increasing in size since the last 6 months. She was initially evaluated in another centre and was diagnosed as a meningioma. She had a history of total thyroidectomy and radioiodine ablation for a non-metastatic papillary carcinoma thyroid (PCT) in the year 2008. She was on a regular follow-up between 2009 and 2012 and during that period her serum thyroglobulin and whole-body iodine scan was normal. However, she was lost to follow-up but she had continued her suppressive doses of thyroxin.

Her T1-weighted MRI showed a lobulated expansile, intensely heterogeneously enhancing lesion arising from the right frontoparietal region (size 77x52x88 cm) (figure 1). The fluorodeoxyglucose-positron emission tomography (PET) CT scan showed a metabolically active expansile soft tissue lesion (standard uptake values, 64) with lytic area and bony spicules (

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