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Query: UMLS:C0153690 (bone metastases)
 6,382 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In the last ten years, 47 patients with distant metastases of differentiated thyroid carcinoma have been treated with 131I following total thyroidectomy. Post-therapy whole body 131I scans revealed detectable uptake in the metastatic lesions in 23 (62%) of 37 patients with lung metastases, 10 (67%) of 15 patients with bone metastases five (71%) of seven patients with mediastinal metastases, and neither of two patients with brain metastases. The concentration of 131I in the metastases was significantly correlated with serum T3 and T4 concentrations, and inversely correlated with serum TSH concentrations. Most of the patients with a strong positive scan were euthyroid, suggesting that thyroid hormones produced by the tumor compensated for hypothyroidism following total thyroidectomy. There was no significant relationship between serum thyroglobulin concentration during T4 replacement therapy and 131I uptake or the efficacy of therapy. Twenty patients with lung (54%), five with bone (33%), two with mediastinal (29%), and none with brain metastases showed tumor regression after treatment. Significantly increased 131I uptake in lung metastases, better therapeutic results and better prognosis were demonstrated in young patients. In conclusion, age, 131I whole body scanning and serum thyroid hormone concentrations are considered to be useful in predicting the efficacy of 131I treatment for distant metastases, especially in the lung.
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PMID:[Results of radioiodine therapy in 47 patients with distant metastases of differentiated thyroid carcinoma]. 189 47

The clinical, histopathologic, immunohistochemical, and electron microscopic findings of two cases of poorly differentiated ("insular") thyroid carcinoma are reported and compared with the 25 cases previously described in the literature. These 27 cases occurred in eight men and 19 women, aged from 34 to 77 years. All but 2 presented with a thyroid mass. Eleven (41%) of the 27 patients experienced local recurrences following surgery, 17 (63%) had development of cervical lymph node metastases, 5 (19%) had development of mediastinal lymph node metastases, 11 (41%) had pulmonary metastases, and 9 (33%) had bone metastases, and 9 (33%) had bone metastases. At least 15 patients (56%) are known to have died of their disease, usually within 8 years of diagnosis. Pathologically, the tumors are distinctive and grow as solid islands (insulae) of small cells separated by artifactually created clefts. In some instances, small follicles are also noted within the insulae. All tumors were positive on immunostaining for thyroglobulin. In view of the propensity for local recurrences and lymphatic and hematogenous dissemination, a total thyroidectomy and neck dissection would seem advisable. Additionally, adjuvant external beam irradiation, systemic chemotherapy, and/or radioactive iodine therapy should also be considered.
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PMID:Poorly differentiated ('insular') thyroid carcinoma. Report of two cases and review of the literature. 220 Apr 44

Thirty (3.8%) of 780 patients with differentiated thyroid cancer seen between 1970 and 1987 had bone metastases. The primary tumor was follicular in 26 patients and papillary in four. Mean age at diagnosis was 61 years. The manifestation of bone metastases was the presenting symptom in 18 patients (60%). Treatment included total thyroidectomy, levothyroxine sodium therapy, and radioactive iodine treatments. Twenty-seven patients had bone metastases from the initial observation, with 44 sites involved. Of the sites, 27 (61%) were shown both on iodine 131 whole-body scan (WBS) and on x-ray film, 11 (25%) only on WBS, and six (14%) only on x-ray film. Multiple involvement was observed in 11 patients. The radiologic appearance was invariably osteolytic. Serum thyroglobulin was elevated in all patients. After radioactive iodine, no WBS+/X-ray+ metastases showed a complete response, although a sclerotic border was noted in several cases, whereas six WBS+/X-ray- lesions were no longer detectable by WBS. Treatment with radioactive iodine and bone surgery resulted in a complete cure in three patients and in a reduction of tumor mass in three. Twenty-one (70%) of the patients died of thyroid cancer after a mean survival of 86 months. Of the nine patients still alive, two are free of disease, three have a good quality of life, and four have severe disability.
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PMID:Clinical and biologic behavior of bone metastases from differentiated thyroid carcinoma. 258 23

Undecalcified methylmethacrylate(MMA)-embedded biopsies and surgical specimens from 20 bone metastases of differentiated or medullary thyroid carcinomas or prostate carcinomas were investigated immunohistologically for the presence of thyroglobulin, cytokeratin, vimentin, and CEA. The immunoreactions on MMA-sections revealed the same staining patterns as those demonstrated using paraffin sections of the primary lesions. Conversely, immunohistological examination of decalcified paraffin-embedded specimens of the same metastases yielded either false-negative results or results that did not allow an exact evaluation. The findings demonstrate the usefulness and limitations of immunohistology when performed on undecalcified plastic-embedded material.
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PMID:Bone metastases of differentiated and medullary thyroid gland carcinomas. Usefulness and limitations of immunohistology performed on undecalcified plastic-embedded tissue specimens. 309 40

In the follow-up of differentiated thyroid carcinoma it is discussed whether the tumor-marker thyroglobulin can replace the 131I scan, especially when the thyroglobulin serum level is normal. A positive 131I scan of metastases in the follow-up of patients with differentiated thyroid carcinoma combined with a low serum thyroglobulin level is extremely rare. The literature shows a frequency of about 4%. Recently we found 3 cases with a positive 131I scan demonstrating pulmonary and bone metastases whereas the serum thyroglobulin level was low.
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PMID:[131I-accumulating pulmonary and bone metastases of differentiated thyroid cancer with low serum thyroglobulin levels--an exception in tumor follow-up?]. 362 22

We investigated the usefulness and limits of serum thyroglobulin, serum calcitonin, and serum tissue polypeptide antigen as humoral markers for thyroid carcinoma in 364 patients with papillary, follicular, medullary, and undifferentiated types of thyroid cancer. In agreement with other studies we found that serum thyroglobulin was a specific and sensitive marker for well-differentiated thyroid cancer after total thyroidectomy. Lymph node, lung, and bone metastases were associated with high serum thyroglobulin concentrations, both during and after thyroid-suppressive therapy with L-thyroxine. Serum thyroglobulin determination was superior to whole body scanning in predicting the presence of differentiated metastases, because patients with nonfunctioning metastases and negative whole body scan also had high levels of serum thyroglobulin. Serum calcitonin levels were increased in all patients with active medullary thyroid cancer, confirming the specificity of this marker in detecting tumors arising from parafollicular C-cells. Furthermore, in medullary thyroid cancer serum tissue polypeptide antigen levels were also increased in most patients. This last substance was found to be increased also in undifferentiated thyroid cancer. Of particular interest was the finding of increased serum tissue polypeptide antigen levels in 15 cases of differentiated thyroid cancer, whose metastases underwent a progressive process of "dedifferentiation."
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PMID:Humoral markers for thyroid carcinoma. 406 37

This report describes a grossly and microscopically distinctive multicystic form of duct carcinoma of the breast which we have termed cystic hypersecretory duct carcinoma. The outstanding morphologic feature is marked secretory activity with the formation of dilated ducts and cysts containing homogeneous, eosinophilic material which resembles thyroid colloid. The inconspicuous epithelium lining the cysts gives rise to micropapillary carcinoma which also occurs in associated ducts. A biopsy that consists entirely of cystic elements, lacking the papillary component, should be termed cystic hypersecretory hyperplasia rather than carcinoma. This may be a persistent condition with the potential to evolve into carcinoma. Eight patients with cystic hypersecretory duct carcinoma were studied, ranging in age from 32 to 78 years (mean 54). In two cases there was coexistent invasive carcinoma, presenting as inflammatory carcinoma with bone metastases in one woman and with a single axillary lymph node metastasis in another. Six patients with intraductal carcinoma treated with mastectomy or local excision have remained well, the longest follow-up being 2 years. Histochemical studies were negative for thyroglobulin in all cases studied. Some lesions were positive for one or more of the following: mucin by mucicarmine stain; carcinoembryonic antigen; alpha-lactalbumin; mouse mammary tumor virus GP52 antigen. Cystic hypersecretory duct carcinoma is morphologically distinguishable from juvenile (secretory) carcinoma and from mucinous (colloid) carcinoma. Longer follow-up and study of additional cases will be necessary to determine if this lesion has distinctive clinical characteristics.
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PMID:Cystic hypersecretory duct carcinoma of the breast. 632 Jun 85

Serum thyroglobulin (tg) levels were measured in 112 patients with proved differentiated thyroid carcinoma (6 pre-operative, 32 post-operative and 74 in whom thyroidectomy was followed by radioiodine treatment). The tg levels were within the normal range in patients who had a residual mass in the neck region after surgery and who were in remission. The patients with metastases showed a wide range (undetectable to microgram quantities) of tg in circulation. The analysis of serum tg with respect to histology showed that the follicular variety of carcinoma tends to show higher tg in serum than the papillary type. Metastatic involvement of bone was associated with much higher serum tg levels than other sites such as lung and lymph node. Thirteen patients with bone metastases of non-thyroidal primary origin had tg levels within the normal range. Serum tg estimation is useful in excluding thyroid as a primary site in patients with bone metastases of unknown primary origin.
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PMID:Serum thyroglobulin differentiated thyroid carcinoma: histological and metastatic classification. 729 54

From 1969 to 1990 there were 309 patients with differentiated thyroid carcinoma (241 papillary and 68 follicular) treated with radioactive iodine for functioning node metastases alone (n = 191) or distant metastases (n = 118) with or without node metastases. These patients represented 32.7% of 945 patients treated in our institution during the same period. Initial treatment included near-total thyroidectomy and 131I ablation of postsurgical thyroid residue, followed by L-thyroxine suppressive therapy. At the end of follow-up (mean 5.8 years), 146 patients (76.4%) in the group with nodal metastases were considered cured, as assessed by clinical and laboratory evaluation including whole body scan (WBS) and serum thyroglobulin (Tg) levels; 32 patients (16.7%) had persistent disease. Loss of 131I uptake in persistent metastatic lesions occurred in five patients (2.6%), and newly developed distant metastases occurred in eight patients (4.2%). Of the patients with distant metastases, 36.4% were cured by 131I. Distant metastases from papillary carcinomas had a higher cure rate than follicular carcinomas (p < 0.01). The metastases of four patients (5.2%) lost the property to take up radioiodine. Lung and bone metastases detectable by WBS but not by radiography were most likely to be cured by 131I. The overall survival at the end of follow-up was 95.8% in patients with only lymph node metastases and 76.0% in those with distant metastases. Tumor-related deaths were 3.6% and 23.7%, respectively. Our data indicate that 131I therapy is highly effective in the treatment of lymph node metastases from differentiated thyroid carcinoma.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Outcome of 309 patients with metastatic differentiated thyroid carcinoma treated with radioiodine. 772 51

Technetium-99m sestamibi (MIBI) is a routinely used myocardial perfusion imaging agent. We have studied groups of patients with differentiated thyroid carcinoma, in order to evaluate the usefulness of this agent in localising regional neck and nodal disease and metastases. There are three groups of patients. Group 1 consisted of patients with known nodal disease or metastases (22 patients) and with raised serum thyroglobulin levels (Tg). Group 2 comprised patients with normal I-131 scans and normal Tg levels (nine patients). Non-thyroid malignancies (six patients) comprised an additional group 3. In group 1, the MIBI scan showed 47 sites of metastases, while the I-131 scan revealed 49 sites. The MIBI scan was positive in two patients where the I-131 scan was negative, while in two other patients, the MIBI study was negative whereas the I-131 scan was positive. In group 2, 6/9 patients had no disease, 2/9 had thyroid remnants, and 1/9 had a fresh primary lung tumour, unrelated to the earlier thyroid cancer. All of them had normal MIBI scans. In group 3, two patients with lung cancer and two with breast cancer and metastases had normal MIBI scans. A further two patients with nasopharyngeal cancer (NPC) had mildly increased MIBI localisation in neck nodes and bone metastases. In summary, Tc-99m sestamibi appears to be as good as I-131 in search for thyroid carcinoma metastatic spread, especially nodal disease and this tracer does not localise well in the primary or metastases of other cancers.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Role of technetium-99m sestamibi in localisation of thyroid cancer metastases. 825 57


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