• Nazneen Liaqat, Samra Shabir, Israr Uddin, Ihtisham Ul Haq, and Shakir Ullah.
• Department of Otorhinolaryngology, Khyber Teaching Hospital, Peshawar, Pakistan.
• J Coll Physicians Surg Pak. 2023 Jan 1; 33 (1): 182018-20.

AbstractPapillary thyroid microcarcinomas (PTMCs) are subcentimetre papillary carcinomas with benign behaviour. Infiltrative follicular subtype of PTMC (IFPTMC) is considered an indolent lesion with propensity to nodal metastasis. Here, we report a case of unifocal IFPTMC with no lymphadenopathy, presenting with fracture of humerus due to metastasis. A 57-year female patient presented with right humerus pathological fracture. MRI of the right humerus revealed a neoplastic deposit. Bone and soft tissue biopsy showed neoplastic cells resembling thyroid carcinoma. The whole body I-131 scan exhibited increased uptake in the right humerus lesion. Total thyroidectomy was performed. The histopathological report of the specimen showed IFPTMC. Treating PTMC aggressively with total thyroidectomy has, no doubt, led to a worldwide epidemic of thyroid cancers. But are we confident enough to render active surveillance as their only treatment? Research work is still needed to identify the prognostic factors of PTMC that could guide clinicians to choose appropriate treatment. Key Words: Thyroid, Papillary microcarcinoma, Follicular subtype, Bony metastasis.

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