Subacute Bulbar Palsy as the Initial Sign of Follicular Thyroid Cancer

We report a 64-year-old woman with follicular thyroid cancer found by subacute bulbar palsy. Progressive bulbar palsy (PBP) was considered the most likely diagnosis, because no abnormal finding was detected on brain CT and blood test except for the decrease of free T4. An echogram of the thyroid rev...

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Veröffentlicht in:	Internal Medicine 2004, Vol.43(10), pp.997-999
Hauptverfasser:	OKUDA, Shiho, KANDA, Fumio, KAWAMOTO, Kunihiko, CHIHARA, Kazuo
Format:	Artikel
Sprache:	eng
Schlagworte:	Acute Disease Biological and medical sciences Biopsy, Fine-Needle Brain - diagnostic imaging Brain - pathology Bulbar Palsy, Progressive - etiology Bulbar Palsy, Progressive - pathology Female General aspects Humans Medical sciences Middle Aged Nervous system (semeiology, syndromes) Nervous system as a whole Neurology PBP like symptoms Radiography skull base metastasis Thyroid Neoplasms - complications
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Zusammenfassung:	We report a 64-year-old woman with follicular thyroid cancer found by subacute bulbar palsy. Progressive bulbar palsy (PBP) was considered the most likely diagnosis, because no abnormal finding was detected on brain CT and blood test except for the decrease of free T4. An echogram of the thyroid revealed a small nodule which was shown to be class IIb by fine needle biopsy. However, 201Tl scintillation examination showed skull base metastasis. Follicular thyroid cancer sometimes seems to manifest as a distant metastasis with no clinically evident thyroid lesion. This case suggested the importance of a detailed survey for malignancy, when subacute bulbar palsy is seen.
ISSN:	0918-2918 1349-7235
DOI:	10.2169/internalmedicine.43.997