J Korean Soc Endocrinol.  1999 Dec;14(4):745-751.

Brain Metastasis from Papillary Thyroid Carcinoma: Report of 2 Cases

• Lee JG
• Lee KY
• Jung YS
• Kim HK
• Park HY
• Kim JH
• Kang MH

Abstract

Papillary carcinoma, the commonest thyroid malignancy, has an indolent clinical course and carries a good prognosis. Metastasis usually occurs to regional lymph nodes, including cervical and upper mediastinal nodes. Distant metastasis is uncommon, lung and bone being the commonest sites. Brain metastasis from papillary thyroid cancer is rare, with a frequency of less than 1% in several reported series and an extremely poor prognosis. The first case was a 74-year-old female patient with papillary cancer who took total thyroidectomy followed by 131I therapy 1 month later. Two days after 131I therapy, she developed headache, vomiting and left hemiplegia. Brain MRI and 131I whole body scan showed solitary brain metastasis in right parietal lobe. After a few weeks her condition improved enough to maintain her usual daily activity despite mild motor weakness. The second one, a 64-year-old female patient presented with headache and vomiting. Two years previously, she had taken total thyroidectomy and 131I ablation therapy after diagnosis of thyroid papillary cancer. Eight months before, she had undergone radical neck dissection because of relapse in cervical lymph nodes. Brain MRI revealed multple metastatic lesions including cerebellum. This patient did not report for follow-up after 2 months of discharge.

MeSH Terms

Aged
Brain*
Carcinoma, Papillary
Cerebellum
Diagnosis
Female
Follow-Up Studies
Headache
Hemiplegia
Humans
Lung
Lymph Nodes
Magnetic Resonance Imaging
Middle Aged
Neck Dissection
Neoplasm Metastasis*
Parietal Lobe
Prognosis
Recurrence
Thyroid Gland*
Thyroid Neoplasms*
Thyroidectomy
Vomiting
Whole Body Imaging