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Selective embolization for hypervascular metastasis from differentiated thyroid cancer: a case series.

Son HY, An SY, Kim EY, Ahn SB, Lee BC - J Med Case Rep (2014)

Bottom Line: Pre-operative percutaneous selective catheterizations of the arteries feeding the metastatic tumors were performed, followed by infusion of gelfoam.The procedures were technically successful in both patients without adverse effects or bleeding.Selective embolization is an effective treatment for bony metastases from thyroid cancer.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology, Thyroid/Head & Neck Cancer Center, Dongnam Institution of Radiological & Medical Sciences, 40 Jwadong-gil, Jangan-eup, Gijang-gun, Busan, South Korea. hyson79@gmail.com.

ABSTRACT

Introduction: The technique of selective embolization has been applied for years in the treatment of vascular anomalies, severe hemorrhage, and for benign and malignant tumors. Some hypervascular skeletal metastases are prone to massive hemorrhage.

Case presentation: We describe the cases of two patients with thyroid carcinoma presenting with neuromuscular symptoms due to large skeletal metastases in the shoulder and sternum respectively. Pre-operative percutaneous selective catheterizations of the arteries feeding the metastatic tumors were performed, followed by infusion of gelfoam. The procedures were technically successful in both patients without adverse effects or bleeding. Complete resections of the skeletal metastases were then performed without substantial bleeding.

Conclusion: Selective embolization is an effective treatment for bony metastases from thyroid cancer.

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Related in: MedlinePlus

A 71-year-old man presented with a painful enlarging mass over the left clavicle. (A) Physical examination. (B) Positron emission tomography reveals a right thyroid tumor with a left clavicular metastasis. (C) Angiographic image from selective catheterization of the left subclavian artery. (D) Follow-up angiography after embolization shows no residual tumoral blush.
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Fig1: A 71-year-old man presented with a painful enlarging mass over the left clavicle. (A) Physical examination. (B) Positron emission tomography reveals a right thyroid tumor with a left clavicular metastasis. (C) Angiographic image from selective catheterization of the left subclavian artery. (D) Follow-up angiography after embolization shows no residual tumoral blush.

Mentions: A 71-year-old man presented to our center with a three-year history of a painful, progressively enlarging mass over his left clavicle and shoulder (Figure 1A). Physical examination revealed a 10×10cm mass of his left clavicle extending to involve his left shoulder. A positron emission tomography-computed tomography showed a right thyroid tumor with bone metastases to his left clavicle and shoulder (Figure 1B). There were also multiple indeterminate nodules in the isthmus and left lobe of his thyroid gland on sonography (Figure 1C). A diagnosis of metastatic thyroid carcinoma was made after an incisional biopsy of the left clavicular mass (Figure 1D). There was heavy bleeding during the biopsy, with a large amount of post-procedural hemorrhagic drainage.Figure 1


Selective embolization for hypervascular metastasis from differentiated thyroid cancer: a case series.

Son HY, An SY, Kim EY, Ahn SB, Lee BC - J Med Case Rep (2014)

A 71-year-old man presented with a painful enlarging mass over the left clavicle. (A) Physical examination. (B) Positron emission tomography reveals a right thyroid tumor with a left clavicular metastasis. (C) Angiographic image from selective catheterization of the left subclavian artery. (D) Follow-up angiography after embolization shows no residual tumoral blush.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4289282&req=5

Fig1: A 71-year-old man presented with a painful enlarging mass over the left clavicle. (A) Physical examination. (B) Positron emission tomography reveals a right thyroid tumor with a left clavicular metastasis. (C) Angiographic image from selective catheterization of the left subclavian artery. (D) Follow-up angiography after embolization shows no residual tumoral blush.
Mentions: A 71-year-old man presented to our center with a three-year history of a painful, progressively enlarging mass over his left clavicle and shoulder (Figure 1A). Physical examination revealed a 10×10cm mass of his left clavicle extending to involve his left shoulder. A positron emission tomography-computed tomography showed a right thyroid tumor with bone metastases to his left clavicle and shoulder (Figure 1B). There were also multiple indeterminate nodules in the isthmus and left lobe of his thyroid gland on sonography (Figure 1C). A diagnosis of metastatic thyroid carcinoma was made after an incisional biopsy of the left clavicular mass (Figure 1D). There was heavy bleeding during the biopsy, with a large amount of post-procedural hemorrhagic drainage.Figure 1

Bottom Line: Pre-operative percutaneous selective catheterizations of the arteries feeding the metastatic tumors were performed, followed by infusion of gelfoam.The procedures were technically successful in both patients without adverse effects or bleeding.Selective embolization is an effective treatment for bony metastases from thyroid cancer.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology, Thyroid/Head & Neck Cancer Center, Dongnam Institution of Radiological & Medical Sciences, 40 Jwadong-gil, Jangan-eup, Gijang-gun, Busan, South Korea. hyson79@gmail.com.

ABSTRACT

Introduction: The technique of selective embolization has been applied for years in the treatment of vascular anomalies, severe hemorrhage, and for benign and malignant tumors. Some hypervascular skeletal metastases are prone to massive hemorrhage.

Case presentation: We describe the cases of two patients with thyroid carcinoma presenting with neuromuscular symptoms due to large skeletal metastases in the shoulder and sternum respectively. Pre-operative percutaneous selective catheterizations of the arteries feeding the metastatic tumors were performed, followed by infusion of gelfoam. The procedures were technically successful in both patients without adverse effects or bleeding. Complete resections of the skeletal metastases were then performed without substantial bleeding.

Conclusion: Selective embolization is an effective treatment for bony metastases from thyroid cancer.

Show MeSH
Related in: MedlinePlus