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01.12.2015 | Case report | Ausgabe 1/2015 Open Access

BMC Musculoskeletal Disorders 1/2015

Metastasis of differentiated thyroid cancer in the subchondral bone of the femoral head: a case report

Zeitschrift:
BMC Musculoskeletal Disorders > Ausgabe 1/2015
Autoren:
Naoki Mizoshiri, Toshiharu Shirai, Ryu Terauchi, Shinji Tsuchida, Yuki Mori, Masazumi Saito, Keiichiro Ueshima, Toshikazu Kubo
Wichtige Hinweise

Competing interests

The authors declare that they have no conflicts of interest.

Author’s contributions

TS, RT, ST, YM and NM diagnosed the Metastasis of differentiated thyroid cancer in the subchondral bone of the femoral head. TS, RT, MS, KU and NM operated this patient. TS, RT, ST and TK were providing valuable advice working on the manuscript. NM, TS, RT, ST and YM wrote the manuscript. MS, KU and TK were proof reading the manuscript, revising it critically. All authors have read and approved the final manuscript.

Abstract

Background

Differentiated thyroid cancer (DTC) is relatively rare and can metastasize to both the lungs and bones. The great majority of bone metastases occur in red marrow regions where blood flow is high. Only one patient has been described with direct DTC metastasis to the subchondral bone of the femoral head.

Case presentation

The patient was a 68-year-old Japanese female who had presented with left hip joint pain at age 63 years. At age 51 years, she had been diagnosed with DTC and underwent partial excision. X-rays showed partial femoral head collapse, suggesting osteoarthritis or idiopathic necrosis of the left femoral head. Three years later, a 131 I whole-body scan showed accumulation in the left femoral head, resulting in a diagnosis of DTC metastasis to the left femoral head. Bipolar hip arthroplasty was performed. Examination of the excised femoral head resulted in a final diagnosis of metastasis of follicular thyroid cancer, which was limited histopathologically to the subchondral bone of the femoral head.

Conclusion

Tumor metastasis to the subchondral bone of the femoral head is exceedingly rare. Overall survival of patients with bone metastasis is improved by complete resection. Differential diagnosis of patients with a previous history of DTC who present with femoral head collapse should include bone metastasis of DTC.
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