O Gagey1, C Court, N Ziad, M Schlumberger. 1. Service d'Orthopédie, Hôpital Bicêtre, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre Cedex. olivier.gagey@bct.ap-hop-paris.fr
Abstract
PURPOSE OF THE STUDY: We report 8 cases of giant metastases in 7 patients with a pelvis or spinal localization in patients with differentiated carcinoma of the thyroid gland. MATERIAL AND METHOD: Surgery was indicated for major functional disorders: pathological fracture, neurological complications. All patients were treated by embolization, tumor resection and reconstruction. All patients were given suppressive doses of thyroid hormones and 6 received complementary radiotherapy. Radioactive iodine, 100 mCu was also given in 5 cases. Outcome was analyzed retrospectively. RESULTS: Two postoperative infections were successfully treated by surgical cleaning in one operation. There were no surgery-related neurological complications. One patient died in the immediate postoperative period due to the cancer. Mean follow-up in the other patients was 4 years. Functional outcome was excellent without local recurrence or mechanical complications. DISCUSSION: These results suggest that surgical resection of giant bone metastases from thyroid carcinomas can provide favorable functional outcome similar to that achieved for small-sized metastases.
PURPOSE OF THE STUDY: We report 8 cases of giant metastases in 7 patients with a pelvis or spinal localization in patients with differentiated carcinoma of the thyroid gland. MATERIAL AND METHOD: Surgery was indicated for major functional disorders: pathological fracture, neurological complications. All patients were treated by embolization, tumor resection and reconstruction. All patients were given suppressive doses of thyroid hormones and 6 received complementary radiotherapy. Radioactive iodine, 100 mCu was also given in 5 cases. Outcome was analyzed retrospectively. RESULTS: Two postoperative infections were successfully treated by surgical cleaning in one operation. There were no surgery-related neurological complications. One patient died in the immediate postoperative period due to the cancer. Mean follow-up in the other patients was 4 years. Functional outcome was excellent without local recurrence or mechanical complications. DISCUSSION: These results suggest that surgical resection of giant bone metastases from thyroid carcinomas can provide favorable functional outcome similar to that achieved for small-sized metastases.