Journal of Korean Endocrine Society 1999;14(4):745-751.
Published online January 1, 2001.
Brain Metastasis from Papillary Thyroid Carcinoma: Report of 2 Cases.
Jung Gu Lee, Ki Young Lee, Yon Sil Jung, Hong Kyu Kim, Hye Young Park, Jong Ho Kim, Moon Ho Kang
1Department of Internal Medicine, Gachon Medical School, Gil Medical Center, Inchon, Korea.
2Department of Nuclear Medicine, Gachon Medical School, Gil Medical Center, Inchon, Korea.
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.
Key Words: Papillary carcinoma, Brain metastasis


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