Spinal Metastasis as Presenting Feature of Follicular Type Thyroid Carcinoma: A Case Report and Review of the Literature

Objective: Follicular type thyroid carcinoma (FTC) rarely presented with spinal metastasis. We aimed to report such a case and to review the literature. Method: A 45 year old male with L2 metastasis of FTC was reported, and other 26 cases were found in literature. Characteristics of the patients and tumors were evaluated. Results: Total 27 patients were 55.2±15 years of age, and male/ female ratio was 12/15. Nineteen patients had paresis of extremities, 9 of them could not mobilize on admission. Total resection of the spinal tumor had been performed in 14 cases and subtotal resection in 5. Radioactive iodine treatment had been added in 20 cases with or without other adjuvant treatment. Twenty-three patients had been followed for 43.7±53.2 months. Only four of them died 214, 66, 36 and 7 months after their presentations. Out of other 19 cases, 13 had been neurologically normal. Type of surgery (total resection versus others) the only factor affecting outcome. In the patients treated with total resection, outcome had been statistically better. Conclusion: Spinal metastasis as initial finding is very rare in the patients with FTC. However, prognosis is quite well with total tumor resection and adjuvant treatment. This cancer type must be kept in mind for differential diagnosis and must be screened in the patients with spinal tumors

Spinal Metastazla Belirti Veren Folliküler Tip Tiroid Karsinomu: Olgu Sunumu ve Literatür Taraması

Amaç: Folliküler tip tiroid karsinomu (FTK) nadiren spinal metastazla belirti verir. Böyle bir olgu sunmayı ve bu konuda literatür taramayı amaçladık. Yöntem: Lomber 2 spinal metastazla belirti veren 45 yaşında erkek FTK olgusu sunuldu ve literatürde benzer 26 olgu bulundu. Tüm olguların özellikleri değerlendirildi. Bulgular: Toplam 27 olgu 55,2±15 yaşındaydı (35-88 arasında, ortalama ± SS) ve erkek/kadın oranı 12/15 idi. Başvuruda 19 olguda kol ve/veya bacaklarda güçsüzlük vardı ve 9’u mobilize olamıyordu. Spinal tümör 14 olguda total, 5 olguda subtotal çıkarıldı. Yirmi olguya radyoaktif iyot tedavisi eklendi. Olguların 23’ü 3-214 ay (43,7±53,2, ortalama ± SS) süreyle izlenmişti, sadece 4 olgu başvurudan 214, 66, 36 ve 7 ay sonra ölmüştü. Halen sağ olan 19 olgunun 13’ü nörolojik olarak normaldi. Uygulanan cerrahi tipi (total çıkarmaya karşılık diğer cerrahi tipleri) son durumu etkileyen tek faktör olarak saptandı. Tümörü total çıkarılan hastalarda sondurum anlamlı olarak daha iyiydi. Sonuç: Folliküler tip tiroid karsinomunun spinal metastazla belirti vermesi çok nadirdir. Ancak total tümör çıkarılması ve adjuvan tedaviyle prognoz iyidir. Spinal tümörlü hastalarda bu kanser tipi de ayrıcı tanıda akılda tutulmalı ve tarama testleri yapılmalıdır

Kaynakça

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