Thyroid carcinoma is the commonest endocrinological malignancy. After papillary thyroid carcinoma (PTC), follicular thyroid carcinoma (FTC) is the second most common histological subtype. Common presentations of FTC include a solitary thyroid nodule and cervical lymphadenopathy. The incidence of individuals diagnosed with thyroid cancer showing initially distant metastatic disease ranges from 1 to 9%. Also, the incidence of solitary bone metastasis from thyroid is only 2 to 3%. We report a case of a patient with FTC whose initial presentation was low back pain and right buttock pain due to vertebral metastasis rather than the usual neck lumps or symptoms of thyroid disease.

Citations

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Objective: To describe the inappropriate application of spinal orthosis and the frequency of the noncompliance and to identify the relating factors for compliance of spinal orthosis in patients with spinal metastasis.

Method: Twenty patients diagnosed as spinal instability due to spinal metastasis and applied with Knight-Taylor thoracolumbosacral orthosis or Knight lumbosacral orthosis were interviewed about the mobility and pain. Visual analogue scale (VAS) about severity of back pain and discomfort was also applied to each patient.

Results: Nine of the twenty patients were considered as being in poor compliance group. Six of eleven patients with good compliance had inappropriate application method or fitting problems. Inability to walk, poor walking endurance, greater degree of discomfort were related to the poor compliance of the spinal orthosis in patients with spinal metastasis.

Conclusion: Even with intensive education about the need for spinal orthosis and the method for application, there is high probability that the patients did not use the orthosis or use the orthosis incorrectly especially when patients cannot walk (or cannot walk enough time) and complain severe discomfort.