Sternal Metastasis and Thyroid Carcinoma: A Rare Combination
Posted: Wednesday, April 7, 2021
Mohammed Ridai, MD, of Ibn Rochd-Casablanca University Hospital Center, Morocco, and colleagues published the case of a woman presenting with sternal metastasis as the first manifestation of papillary thyroid carcinoma. These deep-bone metastases may decrease the survival rate by more than 60%, and very few of these cases have been discovered. This case study was reported in the International Journal of Surgery Case Reports.
The endocrinology service referred a 59-year-old woman who discovered sternal metastasis of papillary thyroid carcinoma by a painless, fixed, and firm presternal mass; it had grown over the course of a year. A plunging goiter with sternal localization was found on a cervicothoracic CT, sternal hyperfixation was discovered by iodine scintigraphy, and stage IVb papillary thyroid carcinoma was confirmed by biopsy. Hyperthyroidism was also discovered, and the woman was treated with levothyroxine.
The patient underwent total thyroidectomy with sternal mass resection and chest wall reconstruction involving two titanium bars and polymesh dual prosthesis. There were no surgical complications, and the patient was extubated and transferred to the ICU for monitoring. Adjuvant 200 mCi radioiodine therapy was administered. She was discharged from the hospital after 4 days.
The biopsied specimen was discovered to be 60% papillary thyroid carcinoma and 40% insular thyroid carcinoma, with bone localization; clavicular, sternal, and coastal resection margins were R0. There were no residual iodine-hungry lesions found in the collarbones or breastbone on post-treatment scans. At a 1-year follow-up, the patient was in good health, and her condition was improving with levothyroxine.
Disclosure: The study authors reported no conflicts of interest.