The authors declare that they have no conflicts of interest.
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.
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.
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.
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.
Bernier MO, Leenhardt L, Hoang C, Aurengo A, Mary JY, Menegaux F, et al. Survival and therapeutic modalities in patients with bone metastases of differentiated thyroid carcinomas. J Clin Endocrinol Metabol. 2001;86:1568–73. CrossRef
Nazario J, Tam AL. Ablation of bone metastases. Surg Oncol Clin North Am. 2011;20:355–68. ix. CrossRef
Lane JM, Sculco TP, Zolan S. Treatment of pathological fractures of the hip by endoprosthetic replacement. J Bone Joint Surg Am. 1980;62:954–9. PubMed
Enneking WF, Dunham W, Gebhardt MC, Malawar M, Pritchard DJ. A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clinical orthopaedics and related research. 1993;241–246.
Schlumberger M, Baudin E, Travagli JP. Papillary and follicular cancers of the thyroid. Presse Medicale. 1998;27:1479–81.
Wexler JA. Approach to the thyroid cancer patient with bone metastases. J Clin Endocrinol Metabol. 2011;96:2296–307. CrossRef
Zettinig G, Fueger BJ, Passler C, Kaserer K, Pirich C, Dudczak R, et al. Long-term follow-up of patients with bone metastases from differentiated thyroid carcinoma -- surgery or conventional therapy? Clin Endocrinol. 2002;56:377–82. CrossRef
Wang W, Larson SM, Fazzari M, Tickoo SK, Kolbert K, Sgouros G, et al. Prognostic value of [18F]fluorodeoxyglucose positron emission tomographic scanning in patients with thyroid cancer. J Clin Endocrinol Metab. 2000;85:1107–13. PubMed
- Metastasis of differentiated thyroid cancer in the subchondral bone of the femoral head: a case report
- BioMed Central
Neu im Fachgebiet Orthopädie und Unfallchirurgie
Mail Icon II