Isolated Calvarial Metastasis from Follicular Thyroid Carcinoma: A Diagnostic and Surgical Challenge

Follicular Thyroid Carcinoma is characterized by hematogenous spread and has a higher propensity for skeletal metastasis compared to other differentiated thyroid carcinomas. Calvarial metastasis, however, remains an exceptionally rare presentation and may occur years after definitive treatment. We report a rare case of isolated calvarial metastasis in a 62-year-old female previously treated for follicular thyroid carcinoma with total thyroidectomy and RAI therapy 2.5 years earlier. She presented with a progressively enlarging right parieto-temporo-occipital scalp swelling associated with headache and intermittent blurring of vision. Imaging revealed a solitary osteolytic calvarial lesion, and histopathological examination confirmed metastatic follicular thyroid carcinoma. This case highlights the indolent yet metastatic potential of follicular thyroid carcinoma and emphasizes the importance of long-term surveillance in treated patients. Reporting such rare presentations may improve clinical awareness, facilitate early recognition of unusual metastatic sites, and support timely multidisciplinary management for improved patient outcomes.

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