AME case reports · 2026
Reconstruction of the chest wall after resection of a locally advanced poorly differentiated thyroid carcinoma with sternal infiltration: case report and literature review.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
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Bouzakri Nabila, Lederer Ann-Kathrin, Zimmer Stefanie, Lang Hauke, Roessner Eric D, Musholt Thomas J
Аннотация
BACKGROUND: The management of advanced thyroid malignancies, particularly poorly differentiated thyroid carcinoma (PDTC), presents significant diagnostic and therapeutic challenges, especially when there is unusual bone involvement. While thyroid cancers typically do not exhibit local invasion to surrounding tissues until advanced stages, this case underscores the necessity for prompt diagnosis and a multidisciplinary approach to treatment to improve patient outcomes. The rarity of sternal infiltration by thyroid cancer and the complexities involved in surgical interventions highlight the need for awareness among healthcare professionals regarding potential diagnoses and treatment pathways.
CASE DESCRIPTION: We present the case of a 52-year-old male who presented with a painful, progressive anterior chest mass that was diagnosed as bone-infiltrating PDTC. Initial evaluations, including imaging and biopsies, revealed extensive infiltration of the sternum and surrounding structures originating from the thyroid gland. Following an interdisciplinary tumour board discussion, the patient underwent an en bloc resection of the thyroid gland along with affected chest structures and reconstruction with human acellular dermis. Postoperatively, he received radioactive iodine therapy. Despite initial management, follow-up imaging at six months indicated the emergence of bone metastases, prompting the initiation of external beam radiation therapy and recommendations for systemic treatment with a tyrosine kinase inhibitor.
CONCLUSIONS: This case illustrates the diagnostic complexities and aggressive treatment required for advanced thyroid malignancies with rare bone involvement. Highlighting the importance of a timely and collaborative approach, it emphasizes that surgical intervention, while challenging, can still offer potential for local control in carefully selected patients. However, the case also serves as a reminder of the necessity for ongoing surveillance and the readiness to adapt treatment strategies in response to emerging metastatic disease, contributing to our understanding of management protocols for similar cases in clinical practice.
CASE DESCRIPTION: We present the case of a 52-year-old male who presented with a painful, progressive anterior chest mass that was diagnosed as bone-infiltrating PDTC. Initial evaluations, including imaging and biopsies, revealed extensive infiltration of the sternum and surrounding structures originating from the thyroid gland. Following an interdisciplinary tumour board discussion, the patient underwent an en bloc resection of the thyroid gland along with affected chest structures and reconstruction with human acellular dermis. Postoperatively, he received radioactive iodine therapy. Despite initial management, follow-up imaging at six months indicated the emergence of bone metastases, prompting the initiation of external beam radiation therapy and recommendations for systemic treatment with a tyrosine kinase inhibitor.
CONCLUSIONS: This case illustrates the diagnostic complexities and aggressive treatment required for advanced thyroid malignancies with rare bone involvement. Highlighting the importance of a timely and collaborative approach, it emphasizes that surgical intervention, while challenging, can still offer potential for local control in carefully selected patients. However, the case also serves as a reminder of the necessity for ongoing surveillance and the readiness to adapt treatment strategies in response to emerging metastatic disease, contributing to our understanding of management protocols for similar cases in clinical practice.