Challenges in the Management of Bone Metastases: Focus on Differentiated Thyroid Cancer and Neuroendocrine Tumors

Bone metastases represent an uncommon but clinically significant complication in endocrine malignancies including differentiated thyroid cancer (DTC) and neuroendocrine tumors (NETs). Although these malignancies typically follow an indolent course, the development of bone metastases is associated with a worse prognosis and increased risk of skeletal related events (SREs). The optimal strategies for the prevention and management of bone metastases in these patients remain unclear and are largely extrapolated from studies in other solid tumors. This presents a unique clinical challenge as treatment decisions need to balance the prevention of SREs against the potential risks of prolonged antiresorptive therapy in patients expected to have a long survival time. This article reviews the clinical complexities involved in managing bone metastases in DTC and NETs. The clinical cases presented highlight key considerations to guide clinical decision-making when treating these specific patient populations.