Open Access Research

Spinal metastasis in thyroid cancer

Sami Ramadan1, Mohamed A Ugas2, Richard J Berwick1, Manisha Notay1, Hyongyu Cho2, Waseem Jerjes3,4,5,6* and Peter V Giannoudis5,6*

Author Affiliations

1 Department of Medicine, University College London Medical School, London, UK

2 Barts and The London School of Medicine and Dentistry, University of London, Queen Mary, London, UK

3 Department of Surgery, Al-Yarmouk University College, Baghdad, Iraq

4 Department of Surgery, UCL Medical School, London, UK

5 Leeds Institute of Molecular Medicine, University of Leeds, London, UK

6 Academic Department of Trauma and Orthopaedic Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, UK

For all author emails, please log on.

Head & Neck Oncology 2012, 4:39 doi:10.1186/1758-3284-4-39

Published: 25 June 2012

Abstract

Background

Thyroid carcinoma generally responds well to treatment and spinal metastasis is an uncommon feature. Many studies have looked at the management of spinal metastasis and proposed treatments, plans and algorithms. These range from well-established methods to potentially novel alternatives including bisphosphonates and vascular endothelial growth factor (VEGF) therapy, amongst others.

The purposes of this systematic review of the literature are twofold. Firstly we sought to analyse the proposed management options in the literature. Then, secondly, we endeavoured to make recommendations that might improve the prognosis of patients with spinal metastasis from thyroid carcinomas.

Methods

We conducted an extensive electronic literature review regarding the management of spinal metastasis of thyroid cancer.

Results

We found that there is a tangible lack of studies specifically analysing the management of spinal metastasis in thyroid cancer. Our results show that there are palliative and curative options in the management of spinal metastasis, in the forms of radioiodine ablation, surgery, selective embolisation, bisphosphonates and more recently the VEGF receptor targets.

Conclusions

The management of spinal metastasis from thyroid cancer should be multi-disciplinary. There is an absence; it seems, of a definitive protocol for treatment. Research shows increased survival with 131I avidity and complete bone metastasis resection. Early detection and treatment therefore are crucial. Studies suggest in those patients below the age of 45 years that treatment should be aggressive, and aim for cure. In those patients in whom curative treatment is not an option, palliative treatments are available.