Pathological Fracture of the Femoral Shaft Following Metastatic Follicular Thyroid Cancer

Follicular thyroid carcinoma (FTC) is characterized by hematogenous spread, most commonly to the lungs and axial skeleton. Metastasis to long bones, particularly the femoral shaft, is rare. We report a case of a 57-year-old man who presented with a pathological fracture of the right femoral shaft 17 years after total thyroidectomy and radioactive iodine therapy for FTC. Imaging revealed a lytic femoral lesion consistent with metastatic disease. The fracture was managed surgically with internal fixation. This case highlights the potential for very late skeletal metastasis in FTC and underscores the importance of lifelong oncological surveillance in thyroid cancer survivors.