Infratemporal metastasis from occult follicular thyroid carcinoma.

An extremely rare case that has not been reported before is described in which metastasis of a follicular carcinoma of the thyroid is resected from the infratemporal fossa. The patient had not been diagnosed of this thyroid pathology. She underwent a left subtemporal preauricular approach, but after this, she had another subtemporal preauricular approach with total thyroidectomy, a facial translocation by degloving, and an endoscopic surgery, because of a local recurrence, and a sella turcica and sphenoidal sinus metastasis. Six years after this, the patient was free of recurrence. Surgical excision of metastatic thyroid lesions may be the only effective treatment but always followed by suppression therapy and whole-body iodine I 131 internal radiation. Stereotactic radiosurgery is a feasible option to treat skull base metastasis of this kind of tumor.