Spinal metastases secondary to thyroid cancer of follicular and parafollicular cell origin are uncommon but may require stabilization of the compromised vertebrae to prevent fracture with spinal cord injury. Such treatment may also relieve pain and improve survival and quality of life.
Summary:
Percutaneous vertebroplasty (PV) is a minimally invasive, radiologically guided procedure whereby bone cement is injected into a structurally weakened vertebra to provide immediate stability. The authors present two cases of thyroid cancer with spinal metastases. Both patients successfully underwent PV. Following PV, the patients experienced significant pain relief with immediate reduction in analgesic requirements and improvement in other symptoms. Both were able to return to their daily activities.
Conclusion:
PV is a minimally invasive spinal procedure and should be considered for patients with metastatic thyroid cancer with spinal metastases.
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References
1.
BruntL, WellsSAJr. 1987. Advances in the diagnosis and treatment of medullary thyroid carcinoma. Surg Clin North Am, 67:263–279.
2.
DuranteC, HaddyN, BaudinE, LeboulleuxS, HartlD, TravagliJP, CaillouB, RicardM, LumbrosoJD, De VathaireF, SchlumbergerM. 2006. Long-term outcome of 444 patients with distant metastases from papillary and follicular thyroid carcinoma: benefits and limits of radioiodine therapy. J Clin Endocrinol Metab, 91:2892–2899.
3.
MuresanM, OlivierP, Lecle'reJ, SirveauxF, BrunaudL, KleinM, ZarnegarR, WeryhaG. 2008. Bone metastases from differentiated thyroid carcinoma. Endocr Relat Cancer, 15:37–49.
4.
ChowS, ChanJ, TiuS, ChoiK, TangD, LawS. 2005. Medullary thyroid carcinoma in Hong Kong Chinese patients. Hong Kong Med J, 11:251–258.
Zanotti-FregonaraP, HindieE, FaugeronI, MorettiL, RavasiL, RubelloD, ToubertM. 2008. Update of the diagnosis and therapy of distant metastases of differentiated thyroid carcinoma. Minerva Endocrinol, 33:1–15.
9.
BöhmP, HuberJ. 2002. The surgical treatment of bony metastases of the spine and limbs. J Bone Joint Surg Br, 84-B:521–529.
10.
BauerHC, WedinR. 1995. Survival after surgery for spinal and extremity metastases: prognostication in 241 patients. Acta Orthop Scand, 66:143–146.
11.
ProyeC, DromerD, CarnailleB. 1992. Is it worth to treat of bone of metastases of differentiated thyroid carcinoma with radioactive iodine?World J Surg, 16:640–645.
PatelSG, ShahJP. 2005. TNM staging of cancers of the head and neck: striving for uniformity among diversity. CA Cancer J Clin, 55:242–258.
17.
HalnanKE, RobertsPH. 1967. Paraplegia caused by spinal metastasis from thyroid cancer. Br Med J, 3:534–536.
18.
ChiJ, GokaslanZ. 2008. Vertebroplasty and kyphoplasty for spinal metastases. Curr Opin Support Palliat Care, 2:9–13.
19.
CheungG, ChowE, HoldenL, VidmarM, DanjouxC, YeeAJ, ConnollyR, FinkelsteinJ. 2006. Percutaneous vertebroplasty in patients with intractable pain from osteoporotic or metastatic fractures: a prospective study using quality-of-life assessment. Can Assoc Radiol J, 57:13–21.
20.
TsengYY, LoYL, ChenLH, LaiPL, YangST. 2008. Percutaneous polymethylmethacrylate vertebroplasty in the treatment of pain induced by metastatic spine tumor. Surg Neurol, 70,Suppl 1:78–83.
21.
HodlerJ, PeckD, GilulaLA. 2003. Midterm outcome after vertebroplasty: predictive value of technical and patient- related factors. Radiology, 227:662–668.
22.
PilitsisJG, RengacharySS. 2001. The role of vertebroplasty in metastatic spinal disease. Neurosurg Focus, 11e1.
23.
PedachenkoYG, KushchayevSV, RogozhinVA, TernitskaiaIuP, GarmishAR. 2004. Puncture vertebroplasty in aggressive hemangiomas of the vertebrae bodies. Zh Vopr Neirokhir Im N N Burdenko, 1:16–20.
24.
BelkoffSM, MathisJM, JasperLE, DeramondH. 2001. The biomechanics of vertebroplasty. The effect of cement volume on mechanical behavior. Spine, 15:1537–1541.
25.
HigginsKB, HartenRD, LangranaNA, ReiterMF. 2003. Biomechanical effects of unipedicular vertebroplasty on intact vertebrae. Spine, 28:1540–1547.
26.
CottenA, DewatreF, CortetB, AssakerR, LeblondD, DuquesnoyB, ChastanetP, ClarisseJ. 1996. Percutaneous vertebroplasty for osteolytic metastases and myeloma: effects of the percentage of lesion filling and the leakage of methylmethacrylate at clinical follow-up. Radiology, 200:525–530.
27.
JanssonKA, BauerHC. 2006. Survival, complications and outcome in 282 patients operated for neurological deficit due to thoracic or lumbar spinal metastases. Eur Spine J, 15:196–202.
28.
MartinJB, GailloudP, DietrichPY, LucianiME, SomonT, SappinoPA, RüfenachDA. 2002. Direct transoral approach to C2 for percutaneous vertebroplasty. Cardiovasc Intervent Radiol, 25:517–519.
29.
TogaoO, MiharaF, YoshiuraT, NoguchiT, KuwabaraY, YoshimitsuK, HondaH. 2005. Percutaneous vertebroplasty in the treatment of pain caused by metastatic tumor. Fukuoka Igaku Zasshi, 96:93–99.
30.
HoffmannRT, JakobsTF, TrummC, WeberC, HelmbergerTK, ReiserMF. 2008. Radiofrequency ablation in combination with osteoplasty in the treatment of painful metastatic bone disease. J Vasc Interv Radiol, 19:419–425.
31.
GersztenPC, MonacoEA3rd. 2009. Complete percutaneous treatment of vertebral body tumors causing spinal canal compromise using a transpedicular cavitation, cement augmentation, and radiosurgical technique. Neurosurg Focus, 27E9.
32.
FisherCG, AnderssonGB, WeinsteinJN. 2009. Spine focus issue. Summary of management recommendations in spine oncology. Spine, 34,22 Suppl:S2–S6.
33.
WengerM. 2003. Vertebroplasty for metastasis. Med Oncol, 20:203–209.
