A 57-year-old man who had a bursting fracture of the fourth lumbar vertebra with thyroid metastatic cancer was reported. The patient fell down from 4 meters height in July 1984, and sustained a fracture of the fourth lumbar vertebra which had been treateated conservatively for eleven months. In June 1985 he was admitted to our hospital because of lumbago and pain of the legs. He had hypesthesia and muscle weakness below a level of the fourth lumbar root segment. Radiographs showed a bursting fracture of the fourth lumbar vertebra, but no osteolytic change.
To obtain the recovery of the paresis, anterior decompression and fusion with Zielke instrumentation was performed. At the time of operation we unexpectedly found the brown soft tissue around the fourth lumbar vertebra with massive hemorrhage. This tissue was a follicular thyroid cancer histologically. He had the history of thyroidectomy for follicular adenoma in 1983,
Finally we made a diagonosis of the thyroid metastatic cancer of the fourth lumbar vertebra.
