title: Management of differentiated thyroid carcinoma with bone metastasis: a case report and review of the Chinese literature.
abstract: Differentiated thyroid carcinoma (DTC) is a common malignancy. The general treatments are thyroidectomy of the affected lobe along with lymphadenectomy. However, bone metastasis is rare in DTC compared with other malignancies and the management of metastasis foci is still controversial. Here we present a case of follicular thyroid carcinoma with the 6th cervical vertebra body metastasis successfully treated by total thyroidectomy, cervical corpectomy, and internal fixation, followed by hormone replacement therapy and radioiodine therapy. Eleven additional patients diagnosed as thyroid carcinoma with bone metastasis collected from Chinese literature between January 1996 and December 2013 were also reviewed. The mean age of the 12 patients at presentation was (53.9±9.2) years (rang, 42-72 years) and the male to female ratio was 1:2. Nine cases received total/near-total thyroidectomy or lobectomy while the other three patients refused for personal reasons. The interventions for bone metastasis were one-stage operation (9/12), I(131) adjuvant therapy (3/12), chemotherapy (1/12), and no intervention (1/12). During the follow-up, two patients died of metastatic carcinoma recurrence, one died of multiple organ metastasis, and one with an unknown reason. We conclude that the management of thyroid carcinoma with bone metastasis needs multidisciplinary cooperation. Surgical resection is still the first choice for cure, while the combined one-stage operation on the primary and metastatic sites followed by hormone replacement therapy and radioiodine therapy is an applicable treatment.
authors.affiliation: Department of Surgery, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China; Department of Surgery, Cixi Red Cross Hospital, Cixi 315300, China.
authors.forename: Wei-dong
authors.initials: WD
authors.lastname: Zhang
authors.forename: Da-ren
authors.initials: DR
authors.lastname: Liu
authors.forename: Cheng-cheng
authors.initials: CC
authors.lastname: Feng
authors.forename: Chuan-biao
authors.initials: CB
authors.lastname: Zhou
authors.forename: Chen-ni
authors.initials: CN
authors.lastname: Zhan
authors.forename: Ri-sheng
authors.initials: RS
authors.lastname: Que
authors.forename: Li
authors.initials: L
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000556:secondary / Q000628:therapy*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000628:therapy*; D009364:Neoplasm Recurrence, Local; D013964:Thyroid Neoplasms / Q000473:pathology / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Bone metastasis; Management; Thyroid carcinoma