Bone metastases from differentiated thyroid carcinoma

  1. G Weryha1
  1. 1Endocrinology Department and2Nuclear Medicine Department, Hôpital Brabois Adultes, CHU Nancy, 54500 Vandoeuvre, France3Clinic of Traumatology and Orthopaedics, 54000 Nancy, France4Digestive and Endocrine Surgery Department, Hôpital Brabois Adultes, CHU Nancy, 54500 Vandoeuvre, France5Department of Surgery, Weill Cornell Medical College, 525 East 68th Street, F-2024, New York, New York 10065, USA
  1. (Correspondence should be addressed to M M Muresan; Email: m.muresan{at}
  1. Figure 1

    The vicious circle at the bone remodeling unit. Tumor cells produce factors that increase the formation of osteoclasts through the RANK-RANKL (receptor activator of nuclear factor-κB ligand) system: IL-6 (interleukin-6), prostaglandin E2 (PGE2), tumor necrosis factor (TNF), macrophage colony-stimulating factor (M-CSF), and parathyroid hormone-related peptide (PTH-rP). During bone resorption, osteoclasts release transforming growth factor-β (TGF-β), insulin-like growth factors (IGFs), fibroblast growth factors (FGFs), platelet-derived growth factor (PDGF), and bone morphogenetic proteins (BMPs), which increase the production of parathyroid hormone-related peptide by tumor cells, as well as growth factors that increase tumor growth. This represents the vicious circle that increases bone destruction and tumor growth. OPG, osteoprotegerin. Adapted from (Clamp et al. 2004, Roodman 2004).

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