Intrathyroideal papillary thyroid carcinoma presenting with a solitary brain metastasis |
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Authors: | Erem Cihangir Hacihasanoglu Arif Sari Ahmet Reis Abdülkadir Alhan Etem Cobanoglu Umit Onder Ersöz Halil Ukinç Kubilay |
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Institution: | (1) Department of Internal Medicine, Division of Endocrinology and Metabolism, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey;(2) Department of Radiology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey;(3) Department of Patology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey;(4) Department of General Surgery, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey;(5) K.T.ü. Tip Fakültesi, Hastaliklari Anabilim Dali, 61080 Trabzon, Turkey |
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Abstract: | Papillary thyroid carcinoma (PTC) is the most common type of well-differentiated thyroid carcinoma and typically has an excellent
prognosis. The incidence of distant metastasis from PTC is low. However, once metastasis has developed in a distant site,
prognosis is markedly diminished. Brain metastases from PTC are extremely rare. No consensus regarding management has yet
been reached. We report on the case of a patient who presented with signs of intracranial hypertension. Cranial magnetic resonance
imaging (MRI) identified a lesion of the right temporofrontoparietal lobe. The patient underwent a craniotomy with a total
removal of the tumor. Histologic examination of the lesion showed a metastasis of papillary adenocarcinoma. We observed a
cold nodule in the right lobe of the thyroid on physical examination and imaging techniques (e.g., CT and scintigraphy). Fine-needle-aspiration
cytology of the nodule was reported as PTC. A total thyroidectomy was performed and histopathological examination showed intrathyroidal
variant of PTC. Postoperatively adjuvant whole brain radiation therapy with 44 Gy to multiple brain metastases of PTC was
applied. One month later, the patient then underwent 131I radioiodine therapy with 150 mCi of 131I given orally. In conclusion, the present case underwent an aggressive multimodal approach therapy. This report indicates
that the early detection and control of brain metastases may contribute to a better quality of life for patients affected
by brain metastases. |
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Keywords: | Papillary thyroid carcinoma brain metastasis management |
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