title: Solitary spinal metastasis of Hürthle cell thyroid carcinoma.
abstract: Hürthle cell carcinoma is a rare variant of differentiated thyroid cancer that occasionally forms distant metastases. However, even in the presence of metastases, patients with Hürthle cell carcinoma have a relatively good prognosis. There are few reports of Hürthle cell carcinoma metastases to the vertebral column, and none describing aggressive resection of spinal metastases. Here, we report a 68-year-old woman with a solitary metastasis of Hürthle cell carcinoma to the T1 vertebral body causing severe kyphotic deformity, myelopathy, and pain. The patient was treated with aggressive excisional decompression of the spinal cord and T1 vertebral body resection from an entirely posterior approach. Reconstruction and stabilization of the anterior spine was accomplished with a transforaminal lumbar interbody fusion allograft spacer and posterior instrumentation. We discuss aspects of the diagnosis, management, patient selection, and surgical treatment of metastatic Hürthle cell carcinoma in reference to the literature.
authors.affiliation: Department of Neurosurgery, Johns Hopkins University, 600 N. Wolfe Street, Meyer 8-161, Baltimore, MD 21287, USA. dsciubb1@jhmi.edu
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Sciubba
authors.forename: Rory J
authors.initials: RJ
authors.lastname: Petteys
authors.forename: Steven
authors.initials: S
authors.lastname: Kang
authors.forename: Khoi D
authors.initials: KD
authors.lastname: Than
authors.forename: Ziya L
authors.initials: ZL
authors.lastname: Gokaslan
authors.forename: Gary L
authors.initials: GL
authors.lastname: Gallia
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Wolinsky
mesh_terms: D000368:Aged; D002277:Carcinoma / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D009765:Obesity; D013125:Spinal Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D013964:Thyroid Neoplasms / Q000473:pathology*; D014057:Tomography, X-Ray Computed / Q000379:methods