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Brain Metastases of Papillary Thyroid Carcinoma with Horner's Syndrome.

Cho SH, Kim SH, Lee JH, Joo WI, Chough CK, Park HK, Lee KJ, Rha HK - Brain Tumor Res Treat (2014)

Bottom Line: And a left frontal mass was incidentally found, and the tumor turned out to be a PTC that had metastasized to brain, regional lymph node, cervical, thoracic spine, and lung.We describe a PTC with extraordinary initial symptoms that metastasized to an unusual site.We recommend that if a papillary thyroid tumor with unusual symptoms or at an advanced stage is found, further investigation should be performed for distant metastasis.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, College of Medicine, The Catholic University of Korea, Yeouido St. Mary's Hospital, Seoul, Korea.

ABSTRACT
Papillary thyroid carcinoma (PTC) is the most common type of thyroid malignancy and has relatively favorable prognosis. Blood-borne metastases of PTC are very rare among the thyroid malignancies. Moreover a case of blood-borne central nervous system metastasized PTC with only unilateral Horner's syndrome, and without any abnormalities in laboratory or physical examinations has not been described before. A 53-year-old female patient had been managed in ophthalmologic clinic due to vague symptoms of right monocular blurred vision with eye dryness for 3 months, but showed no signs of improvement. So it was performed a magnetic resonance imaging and magnetic resonance angiography to evaluate the possibilities of cerebral lesion. And a left frontal mass was incidentally found, and the tumor turned out to be a PTC that had metastasized to brain, regional lymph node, cervical, thoracic spine, and lung. We describe a PTC with extraordinary initial symptoms that metastasized to an unusual site. We recommend that if a papillary thyroid tumor with unusual symptoms or at an advanced stage is found, further investigation should be performed for distant metastasis.

No MeSH data available.


Related in: MedlinePlus

Bone scan with Tc-99m-pertechnetate shows a defect in the left parietal bone, as sequel of the recent craniotomy surgery. There is a metastatic skeletal hot uptake lesion of lower cervical spine.
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Figure 6: Bone scan with Tc-99m-pertechnetate shows a defect in the left parietal bone, as sequel of the recent craniotomy surgery. There is a metastatic skeletal hot uptake lesion of lower cervical spine.

Mentions: After the primary lesion controls, brain surgery was performed 3 weeks later. We planned to use of navigator system for accurate tumor evacuation of the brain. In the navigator CT image, the tumor size had increased significantly to about 3.3×3×3.1 cm, but mainly from the cystic lesion. Craniotomy and gross total tumor removal was done by using of navigator system. The metastasized brain lesion was well marginated from normal parenchyme. The frozen biopsy result of metastasized tumor was adenoma-typed malignancy, but final pathologic confirmation was same pathology of original site. Post-operative follow-up brain MRI image revealed complete removal of left frontal mass with two new small enhanced nodules on the right frontal and occipital lobe (Fig. 5). During the post-operative period, 99mTc pertechnetate bone scan (Fig. 6), and whole spine MRI were performed to evaluate distant metastases. It revealed additional metastases on 7th cervical, and 2nd thoracic vertebral body. We are planning whole brain radiotherapy with 30 Gy for remnant lesion first, then neck lesion radiotherapy and radioactive iodine ablation (131I) for distant metastases.


Brain Metastases of Papillary Thyroid Carcinoma with Horner's Syndrome.

Cho SH, Kim SH, Lee JH, Joo WI, Chough CK, Park HK, Lee KJ, Rha HK - Brain Tumor Res Treat (2014)

Bone scan with Tc-99m-pertechnetate shows a defect in the left parietal bone, as sequel of the recent craniotomy surgery. There is a metastatic skeletal hot uptake lesion of lower cervical spine.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4231621&req=5

Figure 6: Bone scan with Tc-99m-pertechnetate shows a defect in the left parietal bone, as sequel of the recent craniotomy surgery. There is a metastatic skeletal hot uptake lesion of lower cervical spine.
Mentions: After the primary lesion controls, brain surgery was performed 3 weeks later. We planned to use of navigator system for accurate tumor evacuation of the brain. In the navigator CT image, the tumor size had increased significantly to about 3.3×3×3.1 cm, but mainly from the cystic lesion. Craniotomy and gross total tumor removal was done by using of navigator system. The metastasized brain lesion was well marginated from normal parenchyme. The frozen biopsy result of metastasized tumor was adenoma-typed malignancy, but final pathologic confirmation was same pathology of original site. Post-operative follow-up brain MRI image revealed complete removal of left frontal mass with two new small enhanced nodules on the right frontal and occipital lobe (Fig. 5). During the post-operative period, 99mTc pertechnetate bone scan (Fig. 6), and whole spine MRI were performed to evaluate distant metastases. It revealed additional metastases on 7th cervical, and 2nd thoracic vertebral body. We are planning whole brain radiotherapy with 30 Gy for remnant lesion first, then neck lesion radiotherapy and radioactive iodine ablation (131I) for distant metastases.

Bottom Line: And a left frontal mass was incidentally found, and the tumor turned out to be a PTC that had metastasized to brain, regional lymph node, cervical, thoracic spine, and lung.We describe a PTC with extraordinary initial symptoms that metastasized to an unusual site.We recommend that if a papillary thyroid tumor with unusual symptoms or at an advanced stage is found, further investigation should be performed for distant metastasis.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, College of Medicine, The Catholic University of Korea, Yeouido St. Mary's Hospital, Seoul, Korea.

ABSTRACT
Papillary thyroid carcinoma (PTC) is the most common type of thyroid malignancy and has relatively favorable prognosis. Blood-borne metastases of PTC are very rare among the thyroid malignancies. Moreover a case of blood-borne central nervous system metastasized PTC with only unilateral Horner's syndrome, and without any abnormalities in laboratory or physical examinations has not been described before. A 53-year-old female patient had been managed in ophthalmologic clinic due to vague symptoms of right monocular blurred vision with eye dryness for 3 months, but showed no signs of improvement. So it was performed a magnetic resonance imaging and magnetic resonance angiography to evaluate the possibilities of cerebral lesion. And a left frontal mass was incidentally found, and the tumor turned out to be a PTC that had metastasized to brain, regional lymph node, cervical, thoracic spine, and lung. We describe a PTC with extraordinary initial symptoms that metastasized to an unusual site. We recommend that if a papillary thyroid tumor with unusual symptoms or at an advanced stage is found, further investigation should be performed for distant metastasis.

No MeSH data available.


Related in: MedlinePlus