Clavicular Metastasis as an Initial Presentation of Papillary Thyroid Cancer

Fung, Russell; Fasen, Madeline; Warda, Firas; Natter, Patrick; Nedrud, Stacey; Fernandes, Rui; Alkhasawneh, Ahmad; Gandhi, Gunjan Y.

doi:10.1155/2021/6662071

Cited by 2 publications

(2 citation statements)

References 23 publications

(40 reference statements)

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“…Recently, genetic analysis in papillary and follicular thyroid cancers (for example, KRAS , BRAF , RET , and P53 genes) has been considered as a useful tool for identifying an aggressive form, including with a higher risk of distant metastases and/or a radioiodine refractory profile [ 46 ]. In 2023, a new report of a recurrent papillary thyroid carcinoma (harboring both TERT promoter and BRAF V600E mutations) in a 71-year-old woman showed a large recurrent mass involving not only the neck area, but also several local and distant regions, such as the sternal end of the clavicle.…”

Section: Results: Sternal Metastases—a Multidisciplinary Perspective ...mentioning

confidence: 99%

Sternum Metastases: From Case-Identifying Strategy to Multidisciplinary Management

Carsote,

Terzea,

Vasilescu

et al. 2023

Diagnostics

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We aimed to overview the most recent data on sternal metastases from a multidisciplinary approach (diagnosis strategies, outcome, and histological reports). This narrative review based on a PubMed search (between January 2020 and 22 July 2023) using key words such as “sternal”, “manubrium”, and “metastasis” within the title and/or abstract only included original papers that specifically addressed secondary sternal spreading of cancer in adults, for a total of 48 original articles (14 studies and 34 single case reports). A prior unpublished case in point is also introduced (percutaneous incisional biopsy was used to address a 10 cm sternal tumour upon first admission on an apparently healthy male). The studies (n = 14) may be classified into one of three groups: studies addressing the incidence of bone metastases (including sternum) amid different primary cancers, such as prostate cancer (N = 122 with bone metastases, 83% of them with chest wall metastases), head and neck cancers (N = 3620, 0.8% with bone metastases, and 10.34% of this subgroup with sternum involvement); and glioblastoma (N = 92 with bone metastases, 37% of them with non-vertebral metastases, including the sternum); assessment cohorts, including breast cancer (N = 410; accuracy and sensitivity of PET/CT vs. bone scintigraphy is superior with concern to sternum spreading) and bone metastases of unknown origin (N = 83, including a subgroup with sternum metastases; some features of PET/CT help the differentiation with multiple myeloma); and cohorts with various therapeutic approaches, such as palliative arterial embolization (N = 10), thymic neuroendocrine neoplasia (1/5 detected with sternum metastases), survival rates for sternum metastases vs. non-sternum chest wall involvement (N = 87), oligo-metastatic (sternal) breast cancer (3 studies, N = 16 for all of them), oligo-metastatic head and neck cancer (N = 81), conformal radiotherapy (N = 24,215, including an analysis on sternum spreading), and EBRT followed by MR-HIFU (N = 6). Core data coming from the isolated case reports (N = 34) showed a female to male ratio of 1.6; the females’ ages were between 34 and 80 (mean of 57.28) and the males’ ages varied between 33 and 79 (average of 58.78) years. The originating tumour profile revealed that the most frequent types were mammary (N = 8, all females) and thyroid (N = 9, both women and men), followed by bladder (N = 3), lung (N = 2), and kidney (N = 2). There was also one case for each of the following: adenoid cystic carcinoma of the jaw, malignant melanoma, caecum MiNEN, a brain and an extracranial meningioma, tongue carcinoma, cholangiocarcinoma, osteosarcoma, and hepatocellular carcinoma. To our knowledge, this is the most complex and the largest analysis of prior published data within the time frame of our methods. These data open up new perspectives of this intricate, dynamic, and challenging domain of sternum metastases. Awareness is a mandatory factor since the patients may have a complex multidisciplinary medical and/or surgical background or they are admitted for the first time with this condition; thus, the convolute puzzle will start from this newly detected sternal lump. Abbreviations: N = number of patients; n = number of studies; PET/CT = positron emission tomography/computed tomography; EVRT = external beam radiotherapy; MR-HIFU = magnetic resonance-guided high-intensity focused ultrasound; MiNEN = mixed neuroendocrine-non-neuroendocrine tumour.

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Section: Results: Sternal Metastases—a Multidisciplinary Perspective ...mentioning

confidence: 99%

Sternum Metastases: From Case-Identifying Strategy to Multidisciplinary Management

Carsote,

Terzea,

Vasilescu

et al. 2023

Diagnostics

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“…Plasmacytoma, osteosarcoma, Ewings sarcoma, and post-radiotherapy sarcomas may also occur in the collarbone [ 17 ]. Although the literature describes a multitude of malignant lesions that may exist in the clavicle, this is not a common occurrence ( Figure 1 ) [ 18 , 19 , 20 , 21 , 22 , 23 , 24 ].…”

Section: Clavicular Tumors: Diagnosismentioning

confidence: 99%

Clavicular Malignancies: A Borderline Surgical Management

Nistor¹,

Ciuche²,

Cucu³

et al. 2022

Medicina

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Nearly 1% of all bone cancers are primary clavicular tumors and because of their rarity, treating clinicians are unfamiliar with their diagnosis, classification, treatment options, and prognosis. In terms of preserving function and avoiding complications, clavicle reconstruction seems logical; however, further studies are needed to support this measure. Reconstruction techniques are difficult taking into account the anatomical structures surrounding the clavicle. When chest wall defects are present, a multidisciplinary team, including an orthopedist and thoracic and plastic surgeons, is of paramount importance for optimal surgical management. Malignant clavicle tumors may include primary and secondary malignancies and neighboring tumors with clavicular invasion. Surgical resection of complex thoracic tumors invading the clavicles can result in larger defects, requiring chest wall reconstruction, which is a substantial challenge for surgeons. Correct diagnosis with proper preoperative planning is essential for limiting complications. Post-resection reconstruction of the partial or total claviculectomy is important for several reasons, including maintaining the biomechanics of the scapular girdle, protecting the vessels and nerves, reducing pain, and maintaining the anatomical appearance of the shoulder. The chest wall resection and reconstruction techniques can involve either partial or full chest wall thickness, influencing the choice of reconstructive technique and materials. In the present paper, we aimed to synthesize the anatomical and physiopathological aspects and the small number of therapeutic surgical options that are currently available for these patients.

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Clavicular Metastasis as an Initial Presentation of Papillary Thyroid Cancer

Cited by 2 publications

References 23 publications

Sternum Metastases: From Case-Identifying Strategy to Multidisciplinary Management

Sternum Metastases: From Case-Identifying Strategy to Multidisciplinary Management

Clavicular Malignancies: A Borderline Surgical Management

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