DOI: https://doi.org/10.36347/sjmcr.2026.v14i03.040

Pages: 484-486

Follicular thyroid carcinoma (FTC) is a differentiated thyroid cancer characterized by a high propensity for hematogenous metastases, mainly affecting the bones and lungs. Its presentation as cauda equina syndrome (CES) is extremely rare, with few cases reported in the literature. We report the case of a 64-year-old woman admitted for CES secondary to a compressive lumbar metastasis. Histopathological examination revealed a previously undiagnosed FTC. Cervical ultrasonography showed a multinodular goiter with a suspicious EU-TIRADS 5 nodule, and computed tomography (CT) revealed multiple bone and pulmonary metastases, as well as muscular infiltration and left ureterohydronephrosis. The patient died two days after admission due to septic shock secondary to acute pyelonephritis. This case highlights the rarity of a neurological inaugural presentation of FTC and emphasizes the importance of heightened clinical vigilance for early diagnosis.