Complete resorption of the humerus in metastatic thyroid carcinoma: a case report

TL;DR

A 68-year-old woman with thyroid cancer experienced complete humeral resorption due to bone metastasis and opted for conservative treatments over surgery.

Contribution

This case highlights the rare occurrence of complete humeral resorption from thyroid carcinoma and emphasizes treatment decision-making in such scenarios.

Findings

The patient's humeral destruction progressed to complete resorption despite conservative treatments.

The patient maintained partial forearm function and independence in daily activities.

Literature review suggests novel surgical options for bone metastases.

Abstract

Thyroid carcinoma is the most common endocrinological malignancy, but its spread to bone is rare. Particularly, bone metastases leading to complete resorption of the humerus are extremely uncommon. We aimed to explore factors affecting treatment decision in humeral metastasis by presenting a case and analyze the possible treatments via conducting a literature review.

We described a case of a 68-year-old woman experiencing chronic pain in her right upper arm for six years. Clinical, radiological, and pathological evaluations confirmed humeral metastasis from thyroid carcinoma. Surgical treatments like tumor removal or limb amputation were suggested for prolonging life and pain relief, but the patient refused them and pursued conservative managements such as herbal medicine, radioactive iodine (131I) therapy, and Levothyroxine Sodium(L-T4). The humeral destruction aggravated gradually, ultimately leading to complete resorption of her right humerus. The patient could not move her right shoulder, but her forearm motion was almost normal; thus, she could complete most of her daily living activities independently. Surgical treatments such as limb amputation were advised but she still refused them for preservation of the residual limb function and preferred conservative managements.

A personalized multidisciplinary approach is important for patients with bone metastasis. The balance between limb amputation for life-prolonging and pain relief and limb salvage for preservation of residual function and social and psychological well-being should be considered. Our literature review revealed that some novel surgical treatments and techniques are available for bone metastases. This case adds to our current understanding of bone metastases and will contribute to future research and treatments.

The online version contains supplementary material available at 10.1186/s12891-024-07250-2.

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