An unusual presentation of metastatic thyroid carcinoma

A 55-year-old female presented with a 6-year history of a scalp mass. Clinical assessment revealed a non-toxic right thyroid nodule and 18 x 17 cm scalp mass with facial varicosities (Figure 1). A skull X-ray (Figure 2a) and brain computerised tomography (CT) scan (Figure 2b) revealed extensive erosion of the parieto-occipital bones and a lobulated mass extending within the right parietal lobe. Ultrasoundguided core biopsy of the scalp mass confirmed the clinical suspicion of metastatic follicular thyroid carcinoma. A staging CT scan demonstrated lung metastases, but no other bone metastases.