Japanese Journal of Clinical Oncology 31:112-115 (2001)
© 2001 Foundation for Promotion of Cancer Research
Papillary Carcinoma of the Thyroid with Distant Metastases to the Cerebrum: a Case Report
1Department of Internal Medicine, 2Department of Neurosurgery and 3Department of Surgery, Fukui-ken Saiseikai Hospital, Fukui, Japan
Cerebral metastases from papillary carcinoma of the thyroid are a very uncommon condition, but such metastases behave more aggressively and show poor prognosis. These metastases almost always involve concomitant lung or bone metastases which may be the first metastatic sites. Here we report a 53-year-old man with diffuse goiter and cervical lymphadenopathy who developed symptoms of elevated intracranial pressure. Computed tomography demonstrated ring-enhanced lesions showing a severe mass effect in the right cerebrum and a nodule in the right thyroid gland accompanied by swollen lymph nodes. Biopsied specimens of the thyroid nodule demonstrated malignant cells of papillary carcinoma. Surgical excision of the metastatic brain lesions was followed by total thyroidectomy with regional lymphadenectomy. Histological examinations confirmed that the patient had cerebral metastases from papillary carcinoma of the thyroid without other distant metastasis. Neurological abnormality disappeared after surgery and treatment with radioactive iodine (131I) and oral thyroxine were initiated thereafter. This case suggests that the thyroid gland is potentially a primary source of metastatic brain carcinoma. Moreover, early detection of cerebral metastases is crucial because these metastatic lesions can be life threatening, in contrast to the relatively less severe clinical course of this malignancy unless it is associated with any distant metastasis.
+ For reprints and all correspondence: Tsuguhito Ota, Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Funabashi 7–1, Wadanaka-machi, Fukui 918-8503, Japan. E-mail: tsukko@kc4.so-net.ne.jp