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Review
. 2018 Apr;7(2):80-88.
doi: 10.21037/gs.2017.12.08.

Current role of interventional radiology in the management of visceral and bone metastases from thyroid cancer

Roberto Luigi Cazzato  1 , Julien Garnon  1 , Guillaume Koch  1 , Behnam Shaygi  2 , Georgia Tsoumakidou  1 , Jean Caudrelier  1 , Emanuele Boatta  1 , Xavier Buy  3 , Jean Palussiere  3 , Afshin Gangi  1
Affiliations
Review

Current role of interventional radiology in the management of visceral and bone metastases from thyroid cancer

Roberto Luigi Cazzato et al. Gland Surg. 2018 Apr.

Abstract

The metastatic disease from thyroid cancer represents a complex clinical scenario, which mandates a case-based multi-disciplinary approach in tertiary referral centers. Direct localised treatments such as minimally invasive interventional radiology procedures can play a vital role in providing a timely palliative or curative treatment in accordance with the patients' clinical status. In this narrative review, we present the current status of interventional radiology treatments for the management of thyroid cancer distant metastases.

Keywords: Thyroid cancer; bone metastases; cementoplasty; cryosurgery; embolization; osteosynthesis; thermal ablation.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
RFA of lung metastases from DTC. (A,B) Axial CT images showing two biopsy-proven lung metastases (arrows) from DTC in a 65-year-old male patient; (C,D) percutaneous CT-guided RFA was performed with expandable electrodes. This choice was mainly done in order to entrap the para-mediastinal nodule and to pull it back away from the mediastinum to avoid temperature-mediated heating of the phrenic nerve during ablation; (E,F) axial contrast-enhanced CT images obtained at 3 months follow-up showing the complete necrosis of both tumors (arrows). RFA, radiofrequency; DTC, differentiated thyroid carcinoma.
Figure 2
Figure 2
Embolization and vertebroplasty of a vertebral metastasis from DTC. (A) Sagittal contrast-enhanced T1-weighted image showing a painful hyper-vascular C7 metastasis from DTC in a 91-year-old lady; (B,C) due to the advanced age of the patient and the complex anatomy, embolization was preferred to ablation; (D-F) percutaneous CT-guided vertebroplasty was subsequently performed to prevent a secondary compression fracture. DTC, differentiated thyroid carcinoma.
Figure 3
Figure 3
Cryoablation and surgical consolidation of a humeral metastasis from DTC. (A) Coronal contrast-enhanced T1-weighted image showing a painful hyper-vascular metastasis from DTC in the diaphysis of the left humerus in a 60-year-old lady; (B,C) percutaneous CT-guided cryoablation was performed; at the same time hydro-dissection was performed to protect the (D) brachial and the (E) radial nerve; (F) two days later the patient received an inter-locked surgical nailing to prevent a secondary bone insufficiency fracture. DTC, differentiated thyroid carcinoma.
See this image and copyright information in PMC

References

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