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Metastatic Papillary Thyroid Carcinoma in Brain: Report of Three Cases
Author(s) -
Li Jianyi,
Aldape Kenneth D,
Fuller Gregory N,
Powell Suzanne Z
Publication year - 2008
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.22.1_supplement.706.25
Subject(s) - medicine , thyroid carcinoma , thyroid , pathology , brain metastasis , differential diagnosis , radiology , metastasis , cervical lymph nodes , cancer
Background: Papillary thyroid carcinoma (PTC) is the most common thyroid neoplasm. PTC generally carries a good prognosis since it is usually confined to the thyroid and tends to metastasize to regional lymph nodes (ex. cervical and upper mediastinal nodes). Distant metastases occur in only 5 to 14% cases. Brain metastases are extremely rare, occuring in 0.1 to 5% of reported cases. We report 3 cases of total thryoidectomy (TT) for PTC followed by subsequent brain metastases. Case reports: 69‐year‐old man treated with TT, radiation therapy and radioactive iodine six and half years ago who presented with acute onset of headache. MRI showed lesions in right temporal and occipital lobes. 64‐year‐old woman underwent TT more than 15 years ago and presented with a mass in the left temporal lobe involving the lateral ventricle. 50 year‐old man underwent TT 2 years ago and presented with a mass in right frontotemporal lobe. Tissue sections in all cases showed metastatic papillary carcinoma immunoreactive for thyroglobulin and TTF‐1. Conclusion: In general, central nervous system metastases from PTC are associated with high mortality rates. Resection of single metastasis to brain or irradiation of multiple lesions improves long‐term outcome. In patients with brain metastases with unknown primary which exhibit papillary architecture, thyroid origin should be considered in the differential diagnosis.