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. 2012 Jun 25:4:39.
doi: 10.1186/1758-3284-4-39.

Spinal metastasis in thyroid cancer

Sami Ramadan  1 , Mohamed A Ugas, Richard J Berwick, Manisha Notay, Hyongyu Cho, Waseem Jerjes, Peter V Giannoudis
Affiliations

Spinal metastasis in thyroid cancer

Sami Ramadan et al. Head Neck Oncol. .

Expression of concern in

  • Comment: Head and Neck Oncology.
    BioMed Central. BioMed Central. BMC Med. 2014 Feb 5;12:24. doi: 10.1186/1741-7015-12-24. BMC Med. 2014. PMID: 24499430 Free PMC article. Review.

Abstract

Background: Thyroid carcinoma generally responds well to treatment and spinal metastasis is an uncommon feature. Many studies have looked at the management of spinal metastasis and proposed treatments, plans and algorithms. These range from well-established methods to potentially novel alternatives including bisphosphonates and vascular endothelial growth factor (VEGF) therapy, amongst others.The purposes of this systematic review of the literature are twofold. Firstly we sought to analyse the proposed management options in the literature. Then, secondly, we endeavoured to make recommendations that might improve the prognosis of patients with spinal metastasis from thyroid carcinomas.

Methods: We conducted an extensive electronic literature review regarding the management of spinal metastasis of thyroid cancer.

Results: We found that there is a tangible lack of studies specifically analysing the management of spinal metastasis in thyroid cancer. Our results show that there are palliative and curative options in the management of spinal metastasis, in the forms of radioiodine ablation, surgery, selective embolisation, bisphosphonates and more recently the VEGF receptor targets.

Conclusions: The management of spinal metastasis from thyroid cancer should be multi-disciplinary. There is an absence; it seems, of a definitive protocol for treatment. Research shows increased survival with 131I avidity and complete bone metastasis resection. Early detection and treatment therefore are crucial. Studies suggest in those patients below the age of 45 years that treatment should be aggressive, and aim for cure. In those patients in whom curative treatment is not an option, palliative treatments are available.

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Figures

Figure 1
Figure 1
Flow chart illustrating search protocol.
Figure 2
Figure 2
Route of transmission from thyroid to spine.
Figure 3
Figure 3
The proposed recommendations of treatment.
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