Pathological rib fracture as the first and only sign of occult follicular thyroid carcinoma: a rare case report

Abstract

A 51-year-old man presented with pleuritic pain after hearing a breaking sound on the right side of his chest, while lifting a heavy weight. Physical examination revealed crepitation with mild swelling and tenderness over the fourth rib in the mid-axillary line. Thoracic computed tomography showed a mass in the right hemithorax lateral to the fourth rib, suggesting a malignant soft tissue tumor causing bone destruction and a pathological fracture. Since malignancy was reported in the intraoperative frozen-section study, the lesion was removed with the third and fourth ribs. The result of the pathological examination was unexpectedly reported as a metastatic follicular thyroid carcinoma.