Solitary Brain Metastasis from Papillary Thyroid Carcinoma in a Patient with Depression: Report of a Case |
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Authors: | Masayuki Maruyama Shinya Kobayashi Kiyoshi Shingu Hisashi Nagashima Kiyohide Nagamine Yoshio Kasuga Ryoji Kato Fumiko Kameko Jun Amano |
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Affiliation: | (1) Department of Surgery,,;(2) Department of Neurosurgery, and,;(3) Department of Psychiatry, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan, JP;(4) Department of Surgery, Matsushiro General Hospital, 183 Matsushiro, Nagano 381-1231, Japan, JP;(5) Department of Medical Science, Kagawa Prefectural College of Health Science, 281-1 Hara, Muremachi, Kagawa 761-0123, Japan, JP;(6) Shinshu University School of Allied Medical Science, 3-1-1 Asahi, Matsumoto 390-8621, Japan, JP |
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Abstract: | Papillary carcinoma of the thyroid is a common thyroid malignancy with a relatively good prognosis. However, distant metastases may develop and become threatening, particularly to older patients, in a more aggressive manner. We report herein the clinical, radiological, and pathological findings of a patient with papillary thyroid carcinoma who had a solitary cerebral metastasis. The patient had been suffering from depression and had already undergone a hemithyroidectomy for primary thyroid carcinoma, and was known to have metastatic thryoid carcinoma of the lungs and bone. After the removal of the remnant thyroid gland prior to radioiodine (131I) therapy, he developed additional problems related to depression. Electroencephalography played an important role in identifying suspected brain metastasis and computed tomography demonstrated a space-occupying lesion in the left cerebral hemisphere. Consequently, an early removal of intracranial mass could be performed without any further life-threatening complications. Moreover, after removal of the brain mass the patient's depression improved immediately without the use of any antidepressants. This case report indicates the possibility that a patient's depression might be associated with brain metastasis from papillary thyroid carcinoma, and also suggests that an early diagnosis with the appropriate surgical management of a brain metastasis followed by radioiodine therapy could be valuable for achieving a prolonged disease-free period. Received: August 17, 1999 / Accepted: March 24, 2000 |
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Keywords: | Thyroid carcinoma Brain metastasis Depression |
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