The initial presentation of follicular thyroid carcinoma is rarely related to metastatic lesions. Presented here is the case of a 70-year-old woman with the initial presentation of a 13-cm chest wall mass identified as a metastatic follicular thyroid carcinoma. The chest wall lesion had features of a poorly differentiated carcinoma with areas of necrosis, an insular growth pattern focally and increased mitotic activity. A small follicular carcinoma was subsequently identified. The primary tumor was a 1-cm well-differentiated follicular carcinoma with capsular and vascular invasion. This represents a rare presentation of a follicular thyroid carcinoma with initial recognition of a large, dedifferentiated metastatic lesion from a small primary carcinoma. Dedifferentiation and metastasis in the context of microcarcinoma is an exceptionally rare event and suggests other mechanisms may be involved in disease spread other than simply increased cell proliferation.
WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.
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Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.