Metastases in thyroid cancer

introduction

Of the Thyroid cancer can be in four different to form, depending on the prevailing cell type, which express themselves in principle in their Chance of recovery, of their metastasis and in theirs Treatment options distinguish.
There are the papillary and the follicular Shape with a relatively good prognosis as well as the medullary and the anaplastic Cancer, which in most cases is associated with a worse prognosis.
This less favorable prognosis and the associated lower life expectancy can be, among other things, to the early and pronounced metastatic behavior (Metastasis means spread, spread) to explain. Anaplastic cancer, in particular, points in aggressive growth behavior on, which is why it grows well beyond organ boundaries and into the blood- and Lymphatic system can scatter.

Read more about this under Life expectancy in thyroid cancer.

Definition of the term metastasis

The term metastasis means one Daughter tumor formation in Body parts remote from the organs of origin. At the onset of thyroid cancer development, local growth occurs, i.e. to a slow growthwhich does not exceed the surrounding organ capsule. The cancer cells are still from the at this time Thyroid capsule protected and cannot be in blood- or Lymphatic vessels emigrate.
However, if the growth continues, the capsule can broken through will and first cancer cells in surrounding organs or blood or lymph vessels settle. In the case of colonization of neighboring organs, symptoms such as thyroid cancer develop Shortness of breath (narrowed windpipe) and difficulties swallowing (narrowed esophagus) noticeable.

If it spreads via the bloodstream, daughter tumors can form in organs distant from the thyroid gland. Here one speaks of Distant metastases. Common organs for the settlement of distant metastases are lung, brain, chest and bone.

Bone metastases

Diagnosis

The presence of Bone metastases (Skeletal metastases) is by means of Skeletal scintigraphy detected. Here the patient is given a certain substance venous administered which for the Bone formation matters. In the area of ​​bone metastases, the bone-building cells (Osteoblasts) to a New bone formationinto which the administered substance is incorporated.

By using a special camera (Gamma camera) this substance can be made visible throughout the body. Bone metastases are through increased substance enrichment now clear to the doctor.

Symptoms

The most common areas where bone metastases can appear are the Spine, the pelvic bones, as well as the long ones Thigh bone (Femur). In most cases, bone metastases remain for a long time symptomless, but as growth increases, so does the resulting instability (decreasing resilience) to.
Many patients describe increased Back pain such as Sensory disturbances, especially in the Legs. This can be explained by the fact that bone metastases, just like the original tumor in the thyroidcan grow across organs. From a certain size you can access important im Spinal cord lying Nerve tracts pressure and impair the sensitivity of the structures they supply.
Advanced bone metastases can even reduce the stability of the bones to the extent that already harmless falls or injuries to Broken bones (one speaks here of pathological bone fractures) being able to lead.

therapy

The therapy for bone metastases depends heavily on which one Thyroid cancer type as the original tumor with which prognosis is available. Often times it is complete cure not possible anymore. In any case, the patient can have an accompanying Pain therapy are offered in order to maintain the quality of life for as long as possible.
There is also the possibility of one drug therapy With Bisphosphonates. These can come from bone-building cells in the bone be built in and such a thing increased resilience cause.
Many patients with pain from bone metastases will also have one radiotherapy offered, which can be done from inside or outside. From the outside means that a radiation device through the skin radiates onto the bone metastasis, trying to damage the cancer cells. If multiple, blurred bone metastases are available, on the other hand, radiation from the inside is recommended (Radionuclide therapy).
About a venous access are special bone building block-like, radioactive substances injected, which are built into the bone in the area of ​​the metastases, emit lightly radioactively on site and thus damage or kill the cancer cells.
However, it should excessively frequent There is also the possibility of fractures that severely limit the patient's life operative bone stabilization by means of a metal plate or in sections Spinal stiffening (Spinal fusion).

Breast metastases

Diagnosis

If a breast metastasis is suspected, this should be done by means of Breast ultrasound, Mammography or MRI (Magnetic resonance imaging) should be checked as soon as possible. If there is an abnormal finding in the imaging, the next one is done Tissue extraction from the suspicious point (biopsy) under local anesthesia as well as an exact microscopic examination by an experienced pathologist.

Symptoms

Metastases in the chest Thyroid cancer are rather Rare. Since the female breast in each Monthly cycle numerous due to hormonal fluctuations Tissue changes metastases in the breast area are usually only noticeable at an advanced stage.
Easy Indurations, Increases in size as well as a light pulling is usually ascribed to completely normal cycle segments.
At an advanced stage, breast metastases can reach a size in which they can be penetrated by the skin palpable or in some cases even visible. Besides, they can Pain, Redness and severe swelling by causing inflammatory reactions.

therapy

The therapy of breast metastases is very complex and individual. In the presence of individual Metastases can be an irradiation from the outside or in individual cases even a surgical removal achieve relief from the symptoms. In the case of multiple metastases, systemic therapy in the form of a chemotherapy.

Lung metastases

Diagnosis

Metastases in the lungs from a size of 1 cm can be easily seen in a chest x-ray (Chest x-ray) diagnose which is absorbed while standing and when breathing heavily. If lung metastases are present, they appear in the form of round, light areas. Lung metastases with a size of less than 1 cm can only be seen on CT.

Read more on the topic: Chest x-ray (chest x-ray)

Symptoms

Lung metastases Thyroid cancer Just like bone and breast metastases, they become noticeable very late. The main symptoms of advanced lung metastasis are in most cases Shortness of breath and to cough.
The cancer cells are usually located in the walls of the Alveoliwhich turns into the Gas exchange need to expand. The metastasis causes the elasticity the alveolar wall clearly reducedfrom which the symptom shortness of breath (Dyspnea) arises.

therapy

The therapy here should be primarily one Symptom relief by shortness of breath and coughing medicinal reduced. Also are one Irradiation or one chemotherapy possible, depending on whether the original thyroid tumor Radiation or chemosensitive is.

Brain metastases

Diagnosis

For the diagnosis of Brain metastases is always a computed tomographic image (CT), which different cross-sectional images of the Head from different angles and thus can also show small metastases.

Symptoms

The symptoms of brain metastases vary depending on localization and size. Basically, brain metastases mean a highly advanced, usually no longer curable original tumor (Primary tumor) and can only do a lot themselves treated to a limited extent become.

Almost all patients with brain metastases describe persistent, very stressful a headache, against which it is definitely possible, a reasonable Pain therapy initiate.
Are the metastases in the area of ​​the Cerebrum, can also have symptoms like Seizures (there are preventive drugs against seizures), Paralysis, Sensory disturbances, Field losses, Speech disorders and even Personality changes occur, which particularly impair the social life of the patient.
In particularly bad cases, close relatives even speak of being barely able to recognize the patient. If this is the case, the conversation should always go to one psychological specialist companion to be sought.
Other possible complaints with brain metastases are dizziness, Impaired consciousness such as prolonged fatigue. Due to the mass of the metastasis in the brain and thus in the bony skull there is also a Increase in intracranial pressurewhich must be observed and, if necessary, treated. Decongestant medication can help here.

therapy

An operation is only in rare cases justified, as any intervention in the brain can result in permanent damage. Only if there is one single metastasis and at good chance of recovery of the initial tumor of the thyroid gland (e.g. papillary or follicular) an operation makes sense.
Before every surgical procedure, a so-called neoadjuvant ("Neoadjuvant" means "before further therapy") Irradiationwhich is intended to reduce the size of the metastasis a little in order to increase the success of the operation. A chemotherapy has little chance of success in the treatment of brain metastases caused by thyroid cancer and is therefore used relatively little.