Proptosis from Metastatic Thyroid Carcinoma: Case Report and Review

A 70 year old female presented with right sided orbital proptosis since one and half year with past history of thyroidectomy. On examination thyroid swelling was present with right orbital proptosis. Routine blood investigations were normal except the serum thyroglobulin levels, 22000I/U. Histopathological examination (HPE) of the biopsy from the protruding mass from the right orbit showed follicular acini lined with cuboidal cells. CECT (Contrast enhanced computerized tomography) of orbit showed mass in the superior part of retro orbital region eroding the superior wall and extending into right parasellar. A total thyroidectomy was performed and HPE of specimen was suggestive of thyroid papillary carcinoma. For the orbital metastasis patient underwent external beam radiotherapy with 40 Gray in 20 fractions. During her follow up period she was found to have secondary in the left femur metaphysis. Patient refused surgical excision of the bone secondary. Patient is on regular follow up with supportive treatment.