Long-term follow-up of papillary and follicular thyroid carcinomas with bone metastasis

Abstract

The aims of this study were to investigate papillary and follicular thyroid carcinomas with bone metastasis in various clinical presentations and to determine the prognostic factors after multimodality treatment. A retrospective analysis was performed of 3,120 patients with papillary and follicular thyroid carcinoma. Of these patients, 131 (including 97 women, 71.8%) were diagnosed with bone metastasis and underwent follow-up at the Chang Gung Medical Center. Patients with bone metastasis were categorized into two groups. Group A was comprised of patients who were diagnosed with bone metastasis either before thyroidectomy or within 6 months of the initial thyroidectomy (90 patients, 68.7%). Group B was comprised of patients with bone metastasis who received a diagnosis 6 months post-thyroidectomy in the follow-up period (41 patients, 31.3%). After a mean follow-up period of 8.4 ± 7.0 years, there were 88 deaths (67.2%) attributed to thyroid cancer and 13 patients (9.9%) achieved disease-free status. A multivariate analysis showed that older age, early diagnosis, and brain metastasis were each associated with a poor prognosis. The difference in disease-specific mortality rates between groups A and B was significant (p < 0.0001). In conclusion, papillary and follicular thyroid cancers with bone metastasis have a high rate of mortality. Despite this high mortality, 9.9% patients still had an excellent response to treatment.

Bone Metastases from Thyroid Carcinoma of Follicular Origin: A Single Institutional Experience

“…However, in our study, although 39.5% of the patients had a FTC, we did not find different rates in the occurrence of SRE according to histological type. The high percentage of patients with SRE in our series may be the result of a larger number of patients submitted to radiotherapy than in other studies [11, 13]. In addition, in our cohort, the presence of a SRE was not associated with a significant increase in specific mortality at 5- or 10-years, in comparison with patients without SRE which is not consistent with previous reports [11].…”

“…In common with other series, the study population was mainly composed of females and had a median age of > 50 years [11, 13]. Consistent with a recently published systematic review, the patients presented predominantly multiple bone involvement with spine preference [14].…”

Fracture of the Humeral Bone as the First Clinical Presentation of Metastatic Papillary Thyroid Carcinoma in Ibadan

“…Thyroid cancer is the most common malignancy of the endocrine system, with increasing incidence in the past three decades [9]. Welldifferentiated thyroid cancers, including papillary and follicular carcinomas, comprise approximately 85% to 90% of all thyroid cancers and usually have an excellent prognosis following appropriate treatment [10].…”

“…However, bone metastasis was associated with a poorer prognosis when compared to lung metastasis. The mechanisms underlying the tendency of well-differentiated thyroid carcinoma to lead to bone metastasis is not entirely clear [9]. These bone metastases are usually osteolytic and represent an important source of morbidity and mortality in these patients because they may develop severe complications such as pathological fractures and spinal cord compression [9].…”

“…Pathologic fractures occur in about 13% of thyroid carcinoma patients with bone metastasis [20] while bone metastasis is silent in up to 6% of cases. [9] Plain radiographs can show bone destruction and sclerosis in the zone of bone metastases, but lesions may not appear on Xrays for several months before a fracture occurs because the limit of detection of lesions is usually >1 cm [20]. Computerized tomography scan can evaluate the extent of metastatic lesions even in sites difficult to evaluate such as the spine and pelvis and its diagnostic sensitivity for boneseeking cancers is 71-100% [16].…”