Table 2 Clinical characteristics at diagnosis of patients with spinal metastasis from thyroid carcinoma and the therapeutic strategies deployed
Author, Year | Patient No. | Age (yrs), sex at time of symptomatic spine disease | Thyroid cancer histology | TNM stage | Intervention for primary site | Location of spinal metastasis | Signs + symptoms of spinal metastasis/indication for surgery | Intervention for spinal metastasis | Outcome at last follow-up (months) |
|---|---|---|---|---|---|---|---|---|---|
Quan et al., 2012 | 1 | 76, F | FWD | T2 N0 M1 | Total thyroidectomy followed by 131-I (100 mCi) therapy every 3–9 months for 2 years then once a year till disappearance of metastatic uptake | L3 | Intractable pain resistant to non-operative measures and pain and/or paralysis due to bony instability or spinal cord compression by metastatic tumour | L1-4 decompression and stabilization | AWD (60) |
2 | 76, F | FWD | T4 N0 M1 | Lumbar | L4-5 decompression and stabilization | AWD (56) | |||
3 | 60, F | PWD | T1 N0 M1 | L4 | L3-5 decompression and stabilization | AWD (20) | |||
4 | 67, F | FWD | T4 N1 M1 | Thoracic | T3 anterior corpectomy and reconstruction with cement and anterior plate | CR (96) | |||
5 | 45, M | Papillary PDTC, refractory to I-131 | T3 N0 M0 | Thoracic | Intractable pain focal mechanical pain resistant to non-operative measures and due to osteolytic metastases in the absence of significant spinal cord compression or spinal instability. | T8 vertebroplasty, followed by T8-T9 decompression and then T6, T7, and L3 vertebroplasties | DOD (6) | ||
6 | 70, F | PWD | T3 N0 M1 | Thoracic | T9 and L1 vertebroplasty | AWD (48) | |||
7 | 61, F | PWD | T3 N1 M0 | Cervical | C3, non-operative | AWD (17) | |||
8 | 68, F | MTC | T4 N0 M1 | Total thyroidectomy | Thoracic | T12 vertebroplasty | DOD (18) | ||
Demura et al., 2011 | 1 | 55, F | Follicular | - | 7/10 patients had undergone previous total thyroidectomy. Subtotal thyroidectomy was performed in 2 patients. Emergency spinal surgery (TES) was performed due to acute paraparesis in 1 case, followed by total thyroidectomy. Preoperatively, 131-I therapy had been administered in 4 cases (patient 2, 3, 5, and 9); all 4 of these patients showed a poor response to the treatment. | L2 | Preserved motor function, abnormal gait and muscle weakness | SET, TES & intraoperative chemotherapy | DOD (77) |
2 | 56, F | Follicular | - | T7 | Preserved motor function and normal gait | SET, TES & intraoperative chemotherapy | NED (125) | ||
3 | 58, F | Papillary | - | T2 | Preserved motor, non-functional | SET, TES & intraoperative chemotherapy | DOD (27) | ||
4 | 56, F | Follicular | - | L2 | Normal motor function | SET, TES & intraoperative chemotherapy | AWD (86) | ||
5 | 59, M | Papillary | - | T10 | Normal motor function | SET, TES & intraoperative chemotherapy | DOD (62) | ||
6 | 63, F | Follicular | - | T10-11 | Preserved motor, non-functional | SET, TES & intraoperative chemotherapy | AWD (56) | ||
7 | 39, F | Medullary | - | T2, T5-7 | Normal | SET, TES & intraoperative chemotherapy | AWD (52) | ||
8 | 77, F | Follicular | - | T7, T10 | Preserved motor function, abnormal gait and muscle weakness and bladder paralysis | SET, TES & intraoperative chemotherapy | AWD (45) | ||
9 | 57, F | Follicular | - | T11 | Normal motor function | SET, TES & intraoperative chemotherapy | AWD (36) | ||
10 | 52, F | Papillary | - | L2-4 | Normal motor function | SET, TES & intraoperative chemotherapy | NED (36) | ||
De Vries et al., 2008 | 1 | 60, F | FWD | T1 N0 M1 | Total thyroidectomy and I-131 therapy | L4 | Pain and neurological symptoms | SET, external beam radiotherapy & corporectomy L4 | Symptoms decreased during 17 sessions (mean duration of 8.1 months), were unchanged during 8 sessions, and increased during 6 sessions (p < 0.01). |
2 | 62, F | FWD | T2 N0 M1 | T5-7 | Pain and neurological symptoms | SET & external beam radiotherapy | |||
3 | 65, F | FWD | T2 N0 M1 | L3- 4 | Pain and neurological symptoms | SET | |||
4 | 40, F | FWD | T4 N0 M1 | L5 | Pain and neurological symptoms | SET & external beam radiotherapy | |||
5 | 77, F | FWD | T2 N0 M1 | L2 | Pain and neurological symptoms | SET & external beam radiotherapy | |||
6 | 54, F | FWD | T2 N0 M0 | T10-11 | Pain and neurological symptoms | SET & external beam radiotherapy | |||
7 | 35, M | FWD | Tx N0 M0 | L2-4 | Pain and neurological symptoms | SET & external beam radiotherapy | |||
8 | 52, F | FWD | Tx N0 M1 | L3 | Pain and neurological symptoms | SET & corporectomy L3 | |||
9 | 45, F | FWD | T3 N0 M1 | C4 | Pain and neurological symptoms | SET & corporectomy C4 | |||
10 | 83, M | FWD | Tx N0 M1 | C5-6 | Pain and neurological symptoms | SET & surgical C5–C6 | |||
Hindie à et al., 2007 | 1 | 27, F | FWD (Hurthle areas) | T2 NX | Total thyroidectomy and 131-I ablation therapy (100 mCi) | T2 | Back pain | Spinal surgery + radiotherapy | PR (43) |
2 | 34, F | PWD | T3 NX | L4 | Asymptomatic, metastases revealed via 131-I ablation therapy | - | CR (8) | ||
3 | 48, M | PWD | T1 NX | T6, L2 | Asymptomatic, metastases revealed via 131-I ablation therapy | - | CR (37) | ||
4 | 53, M | Follicular, PDTC | T4a N1b | T6 | Back pain | Spinal surgery + radiotherapy | DOD (76) | ||
5 | 55, M | PWD (Hurthle areas) | T1 Nx | T11, L3 | Asymptomatic, metastases revealed via 131-I ablation therapy | - | CR (23) | ||
6 | 63, F | FWD | T2 NX | T10-11 | Back pain | Spine radiotherapy | DOD (32) | ||
7 | 75, F | FWD | T3 N0 | T12 | Back pain | Spinal surgery + radiotherapy | PD (62) | ||
8 | 65, F | PWD | T4b N1b | C6 | Asymptomatic, metastases revealed via 131-I ablation therapy | Spine radiotherapy | DOD (34) | ||
9 | 73, M | Hürthle | T3 N1b | Cervical | Bone pain | Spine radiotherapy | DOD (5) | ||
Eustatia-Rutten et al., 2003 | 1 | 69, M | FTC, DTC | T4 N1 M1 | Total thyroidectomy and 131-I ablation therapy (76–162 mCi) ± second 131-I therapy, irradiation and/or laminectomy | L1-4 | Radicular pain/SSC, hyperaesthesia | SET and 131-I ablation therapy (76–162 mCi), laminectomy and irradiation | DOD (54) |
2 | 51, M | FTC | Tx Nx M0 | T1 | Radicular pain | SET | DOD (124) | ||
3 | 72, F | PTC | T4 N0 M1 | T1 | Paresis, incontinence | SET then laminectomy & irradiation | DOD (1.5) | ||
4 | 71, F | PTC | T4 N0 M1 | L3 | Radicular pain/SSC, | SET then irradiation | PD (139) | ||
5 | 62, M | FTC | T4 N0 M0 | T10, T12 | Radicular pain | SET | DOD (63) | ||
6 | 60, M | FTC | T2 N0 M1 | C7 | SSC, paraplegia, radicular pain | SET then 131-I therapy (76–162 mCi) and irradiation | DOD (86) | ||
7 | 53, F | FTC | T2 N0 M0 | L1 | Radicular pain, hyperaesthesia, paraesthesia | SET | PD (108) | ||
8 | 45, M | FTC | T3 N0 M0 | T1-3, T5-7 | Radicular pain, paraparesis, ataxia, paraplegia | SET then 131-I ablation therapy (76–162 mCi), laminectomy and irradiation | PD (152) | ||
9 | 72, M | PTC | Tx N1 M1 | T9-10 | Radicular pain, | SET | DOD (12) | ||
10 | 62, M | PTC | T3 N0 M0 | T9-10 | paraparesis, incontinence, hyperaesthesia, paraplegia, radicular pain | SET | DOD (102) | ||
van Tol et al., 2000 | 1 | 77, F | PWD | T2 N1 M1 | Total thyroidectomy and 131-I ablation therapy (150 mCi) | L2 | Severe pain and neurological symptoms | SET then 131-I therapy (150 mCi) | AWD (40) |
3 | 63, F | FWD | T2 N0 M1 | T7 | Severe pain, neurological symptoms and SCC | SET then 131-I therapy (150 mCi) | CR (38) | ||
4 | 60, F | FWD | T2 N0 M1 | L4 | Severe pain, neurological symptoms and SCC | SET then 131-I therapy (150 mCi) | CR (21) | ||
Vitale et al. 2001 | 1 | 35, F | FWD | - | Not specified; failure of all conventional therapy | Spine | Painful bone metastases | 1 year monthly course of I.V. pamidronate (90 mg) | PR (12) |
|  | 2 | 76, F | PWD | - |  | Spine | Painful bone metastases | 1 year monthly course of I.V. pamidronate (90 mg) | AWD (12) |
|  | 3 | 48, F | FWD | - |  | Spine | Painful bone metastases | 1 year monthly course of I.V. pamidronate (90 mg) | PR (12) |
|  | 4 | 46, F | FWD | - |  | Spine | Painful bone metastases | 1 year monthly course of I.V. pamidronate (90 mg) | AWD (12) |
|  | 5 | 54, F | MTC | - |  | Spine | Painful bone metastases | 1 year monthly course of I.V. pamidronate (90 mg) | PD (12) |
|  | 6 | 66, F | MTC | - |  | Spine | Painful bone metastases | 7 monthly course of I.V. pamidronate (90 mg) | PD (12) |
|  | 7 | 61, M | FWD | - |  | Spine | Painful bone metastases | 1 year monthly course of I.V. pamidronate (90 mg) | AWD (12) |