PLUMMER’S PATIENT WITH DISTANT METASTASIS CARCINOMA THYROID: A CASE REPORT

Abstract

Plummer's patient with Distant Metastatic Carcinoma Thyroid: A Case Report. 5% to 10% of patients with papillary thyroid carcinoma (PTC) have locoregional metastases, whereas distant metastases are particularly unusual. Only 4% of thyroid carcinoma (TC) patients develop bone metastases, which makes them poorly understood but still significantly increases morbidity and mortality. Clinical therapy and rehabilitation might be seriously affected by bone resorption forced on by thyroid cancer. A 58-year-old woman came with complaints of pain in her right groin 5 months before hospital admission. Previously the patient had a history of slipping about 1 year ago and caused walking difficulty. In addition to pain in the groin, the patient feels that his heart is beating frequently, gets tired easily, loses weight, accompanied by hair loss which is felt for about 6 months. Further examination revealed low TSH with Plummer history and also suspected right and left thyroid masses (TIRADS 4). Thyroid scan examination showed cold nodules on both thyroids and bone scan examination found metastatic lesions with pathological fractures in the neck of the right femur accompanied by C5-7 metastatic lesions. Instead of being simply the result of tumor invasion into bone, the pathophysiology of bone metastasis seems to represent a cooperative relationship between cancer and the bone microenvironment that results in a "destructive cycle" of bone degradation. Furthermore, follicular and medullary thyroid tumors are more likely to develop bone metastases, suggesting careful bone surveillance in individuals with these histology. Well-differentiated thyroid carcinoma has a median survival of only 4 years in the presence of bone metastases. Compared to local lymph node and lung metastases, bone metastases are frequently ignored and understudied. The osseous sites were the preferred sites for distant metastases in thyroid carcinoma linked to Plummer's disease because of their aggressive biological behavior. A missed bone metastasis at an initial diagnosis could have a negative impact on a patient's quality of life and prognosis, even if well-differentiated thyroid cancer is typically indifferent.