Complete diaphysis resorption of the femur: A case report in a metastatic papillary thyroid cancer
| Autor: | Ery Kus Dwianingsih, Suwardjo Suwardjo, Wirsma Arif Harahap, Widya Surya Avanti, Sumadi Lukman Anwar |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
endocrine system
medicine.medical_specialty medicine.medical_treatment Papillary thyroid cancer Case Report Bone resorption WHO World Health Organization Metastasis Thyroid carcinoma 03 medical and health sciences 0302 clinical medicine medicine Thyroid cancer TSH Thyroid Stimulating Hormone business.industry Thyroid Bone metastasis Neck dissection General Medicine medicine.disease medicine.anatomical_structure 030220 oncology & carcinogenesis CTscan Computed Tomography scan 030211 gastroenterology & hepatology Surgery Radiology business Delayed diagnosis |
| Zdroj: | Annals of Medicine and Surgery |
| ISSN: | 2049-0801 |
| DOI: | 10.1016/j.amsu.2020.11.076 |
| Popis: | Introduction Although differentiated thyroid cancers generally have a good prognosis, a small proportion of patients will have recurrent or progressive disease. Bone resorption due to thyroid cancer can cause significant challenges in the clinical management and rehabilitation. Presented case Nearly total femur resorption was found as a first presentation in a patient with thyroid cancer. The patient complained about chronic pain in her left thigh that had progressed into an inability to walk. She was treated by a traditional healer for six years before she was persuaded by a social worker to seek medical help. X-rays showed pathological loss of the right diaphyseal femur. Neck CT-scan showed a left thyroid mass with tracheal deviation, with multiple lytic lesions in the sternum and 5th rib. Needle biopsy of the thyroid mass resulted in an inconclusive follicular neoplasm. Total thyroidectomy and neck dissection revealed a classical type of papillary thyroid carcinoma. After thyroid ablation, she opted for palliative radiotherapy and bisphosphonate treatment for the bone metastases. Discussion Bone metastases are rarely detected at the time of thyroid cancer diagnosis. In the presence of bone metastasis, median survival of well-differentiated thyroid cancer decreases into only 4 years. Bone metastases are often neglected and less studied than regional lymph node and lung metastases. Conclusion Although well differentiated thyroid cancer is usually indolent, a neglected bone metastasis at an initial diagnosis might adversely affect patient's quality of life and prognosis. Highlights • Although differentiated thyroid cancer is usually indolent, delayed diagnosis might adversely affect the outcome. • Macro-metastases in the bone might cause poor functioning and prognosis. • Public education about high-risk thyroid cancer is important to prevent from neglected cases. |
| Databáze: | OpenAIRE |
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