Surgical Treatment of Sternal Metastases From Thyroid Carcinoma: Report of Two Cases

Abstract

Radioiodine therapy is currently the treatment of choice for metastasizing differentiated thyroid cancer (DTC); however, skeletal metastases are resistant to this form of therapy. The surgical removal of distant metastases from DTC offers the best chance for prolonged survival and improved quality of life. Furthermore, the surgical removal of a resectable skeletal metastasis can be a valuable complement to radioiodine therapy. This report describes two cases of sternal metastases from thyroid carcinoma that were managed successfully by surgery involving partial excision of the sternum followed by reconstruction of the chest wall with Marlex mesh. Both patients recovered uneventfully. Sternal resection with Marlex mesh reconstruction of the chest wall defect proved a simple and effective method for managing sternal metastasis. Thus, the surgical resection of distant bony metastases in patients with DTC is recommended as it can be curative, provide symptomatic palliation, or allow for more effective radioiodine treatment.

Resection of Sternal Metastasis from Endometrial Carcinoma Followed by Reconstruction with Sandwiched Marlex and Stainless Steel Mesh: Report of a Case

“…Marlex mesh used alone or in combination with a pedicled musculocutaneous flap is now used frequently in chest wall reconstruction. 1,[6][7][8][9][10][11] Marlex mesh is easy to handle, has good assimilation with the surrounding soft tissues, is resistant to infection, and is radiotransparent. 12 Its main drawback lies in its limited resilience, even when sutured in traction, and it can result in a flail chest if the skeletal defect is large.…”

Thyroid folicular carcinoma with mediastinal cervical metastasis and papillary pattern presence: A rare phenomenon

“…A higher stage generally requires radiotherapy with radioactive iodine, occasionally with high doses of up to 200 mCi, to remove remnant local thyroid tissue and distant metastatis [11]. External beam radiation for metastasis is not widely used, since That there are conflicting reports [12]. In the case presented, no tumordirected treatments were performed because the patient dies because of the superior vena cava syndrome.…”

Sternal Mass as First Presentation of Follicular Thyroid Carcinoma

“…They are commoner in male than in female patients, and in older patients. Bone metastases confer poorer prognosis on affected patients as they are usually not cured with RAI therapy [12,13]. Durante et al [14] described metastases as being commoner in follicular than in papillary thyroid cancer; 7-28% vs. 1.4-7%, respectively.…”