International Session 23　　Thyroid 1

We report a rare case of thyroid carcinoma with an intraluminal tumor embolus of the internal jugular vein that later progressed cranially and caused multiple cranial neuropathies.An 80 year old woman presented with a right cervical mass that had enlarged over 10 years.Ultrasonography revealed a cystic mass in the right neck and thyroid calcifications.Magnetic resonance imaging at initial presentation demonstrated a cystic lesion with dilatation of the internal jugular vein and intraluminal signal heterogeneity.Fine needle aspiration of right cervical mass was nondiagnostic due to cystic degeneration.During follow up, the patient developed facial paralysis, tongue deviation, and unilateral vocal cord paralysis, suggesting cranial extension.Biopsy of right cervical mass confirmed papillary thyroid carcinoma with a poorly differentiated component.The patient chose best supportive care and died four months after diagnosis.This case suggests that venous tumor embolism may initially present with venous dilatation and later promote cranial extension.Awareness of this progression is important because skull base neurological symptoms may indicate advanced thyroid carcinoma. IS-１３２A Case Report : Follicular thyroid carcinoma with bony metastasis