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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 64-year-old woman presented with an enlarging mass of the upper sternum. (A) Physical examination. (B) Positron emission tomography showed a right thyroid tumor with a sternal metastatic lesion. (C) Angiographic image from selective catheterization of the left internal mammary artery. (D) Follow-up angiography after embolization reveals no residual tumoral blush.
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Fig2: A 64-year-old woman presented with an enlarging mass of the upper sternum. (A) Physical examination. (B) Positron emission tomography showed a right thyroid tumor with a sternal metastatic lesion. (C) Angiographic image from selective catheterization of the left internal mammary artery. (D) Follow-up angiography after embolization reveals no residual tumoral blush.

Mentions: A 64-year-old woman presented to our center with a painful hard mass over the upper part of her sternum. She had a history of a thyroid tumor 30 years ago but did not undergo surgery. The sternal mass was progressively enlarging and had been present for a month. On physical examination, a 4.0×3.7cm mass was found in her upper sternum extending to the region of the clavicular heads.Positron emission tomography-computed tomography revealed a 3.3cm tumor in her right thyroid gland and another 4.0cm upper sternal osteolytic mass (Figure 2B). A diagnosis of metastatic follicular carcinoma was made via fine-needle aspiration cytology of the sternal mass.Figure 2


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 64-year-old woman presented with an enlarging mass of the upper sternum. (A) Physical examination. (B) Positron emission tomography showed a right thyroid tumor with a sternal metastatic lesion. (C) Angiographic image from selective catheterization of the left internal mammary artery. (D) Follow-up angiography after embolization reveals 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

Fig2: A 64-year-old woman presented with an enlarging mass of the upper sternum. (A) Physical examination. (B) Positron emission tomography showed a right thyroid tumor with a sternal metastatic lesion. (C) Angiographic image from selective catheterization of the left internal mammary artery. (D) Follow-up angiography after embolization reveals no residual tumoral blush.
Mentions: A 64-year-old woman presented to our center with a painful hard mass over the upper part of her sternum. She had a history of a thyroid tumor 30 years ago but did not undergo surgery. The sternal mass was progressively enlarging and had been present for a month. On physical examination, a 4.0×3.7cm mass was found in her upper sternum extending to the region of the clavicular heads.Positron emission tomography-computed tomography revealed a 3.3cm tumor in her right thyroid gland and another 4.0cm upper sternal osteolytic mass (Figure 2B). A diagnosis of metastatic follicular carcinoma was made via fine-needle aspiration cytology of the sternal mass.Figure 2

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