# Unusual Skull Metastasis From Thyroid Cancer: A Case Report

## TL;DR

A rare case of skull metastasis from thyroid cancer in an older adult is reported, where the primary tumor could not be found in the thyroid gland.

## Contribution

This case report highlights the rare occurrence of skull metastasis from thyroid cancer without detectable primary thyroid malignancy.

## Key findings

- Skull metastasis from papillary thyroid carcinoma was diagnosed after tumor resection and orbital exenteration.
- No malignancy was found in the thyroid gland despite total thyroidectomy.
- Only two prior cases of skull metastasis without a detectable primary thyroid tumor have been reported.

## Abstract

Papillary thyroid carcinoma is a common condition, but skull metastases are extremely rare. This case involves an older adult who presented with a progressively growing mass in the skull that also involved the orbit. Imaging revealed a lesion measuring 85x76x91 mm, causing compression of the left frontal lobe and midline deviation. The patient underwent craniotomy with tumor resection and orbital exenteration, which led to the diagnosis of metastasis from papillary thyroid carcinoma. A total thyroidectomy was later performed, but histopathology found no evidence of malignancy in the thyroid gland.

Skull metastasis in patients with thyroid cancer is rarely reported, and its diagnosis, as well as pre-and postoperative management, remains uncertain. Additionally, the occurrence of metastasis without identifying the primary tumor in the thyroid gland is an uncommon phenomenon. Only two previous cases have been reported where skull metastasis occurred without a detectable primary thyroid tumor. Skull metastases are rare, and diagnosing and treating them presents significant challenges. However, a skull metastasis originating from the thyroid, even in the absence of a primary tumor, is a rare but real possibility.