The cytodiagnosis of metastasis of follicular thyroid carcinoma in the scalp: an unusual case report

Follicular thyroid carcinoma is known to metastasize to distant places even before the primary follicular thyroid carcinoma is clinically obvious. One such unusual and distant metastasis of follicular thyroid carcinoma is its subcutaneous location. The present case report is an unusual one. A 50-year-old man with a history of trauma on the scalp developed non resolving hematoma. The swelling was soft with greenish discolouration to the skin over it. The swelling was soft with greenish discolouration to the skin over it. The Fine Needle Aspiration Cytology (FNAC) of the swelling revealed the classic cytomorphology of metastatic follicular thyroid carcinoma. The clinical examination of thyroid was normal at this juncture cytodiagnosis. The USG of the thyroid showed a deeply placed nodule of higher Thyroid Imaging Reporting & Data System (TIRAD). The FNAC from this nodule was also performed. The diagnosis of follicular neoplasm favoring follicular thyroid carcinoma was offered. The patient underwent thyroidectomy. The histological examination of tumor tissue was consistent with the diagnosis of thyroid follicular carcinoma. This case offers a unique insight into the non-resolving hematoma harboring the metastatic lesion of follicular thyroid carcinoma in the patient with the silent primary in the thyroid.