Limits...
Solitary bone and brain metastasis in a patient with papillary thyroid carcinoma mimicking cavernous angioma

View Article: PubMed Central - PubMed

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

In particular, brain metastasis is very rare and is reported in only 1% of patients with thyroid carcinoma... The final pathological diagnosis was metastatic columnar cell-variant PTC, which is a very rare variant... The present patient was diagnosed with the columnar cell variant, which is characterized by pseudostratified columnar cells and subnuclear vacuolization that resembles early secretory endometrium... Although this PTC variant is very rare and only accounts for 0.15% to 0.2% of all PTCs, it is associated with aggressive behaviors such as a propensity for extrathyroidal extension, distant metastasis, and the death of the tumor... The prevalence of TgAb in thyroid malignancy patients is 10% to 30%, which is higher than among the normal population, and a high serum TgAb titer decreases after thyroid malignancy treatment while a sustained high serum TgAb titer could reflect early relapse... The survival rate of PTC patients significantly decreases when metastasis occurs... The common symptoms of patients with thyroid carcinoma and brain metastasis include headache, nausea, motor weakness, gait disturbances, sensory deficits, visual loss, and seizures but some patients with brain metastasis do not exhibit any symptoms and are only diagnosed with brain metastasis upon a postmortem examination... Due to the low incidence of brain metastatic PTC, a universal standard treatment protocol has yet to be established... However, the current treatment of choice is typically surgical resection because the removal of a brain metastasis significantly improves survival and is an independent predictor of better outcomes... Radiosurgery should be considered for patients who are unable to undergo surgery and whole brain radiation therapy can also be used to treat multiple metastases... Although brain radiation is not associated with a survival benefit, several cases have been reported indicating a regression of brain metastasis after such therapy... The present case was an extremely rare example of brain metastasis from columnar cell-variant PTC in which the brain metastatic lesion mimicked a cavernous angioma... These findings suggest that, depending on the PTC variant, even small PTCs should be treated with caution because they can lead to brain metastasis.

No MeSH data available.


Radiological findings. (A) T1-weighted brain magnetic resonance image showing low mixed signal intensity (arrow). (B) T2-weighted image showing an isointense-to-hypointense lesion (arrow). (C) Chest computed tomography scan showing a 52mm mass with necrosis on the manubrium of the sternum (arrow).
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC5016272&req=5

f1-kjim-2014-321: Radiological findings. (A) T1-weighted brain magnetic resonance image showing low mixed signal intensity (arrow). (B) T2-weighted image showing an isointense-to-hypointense lesion (arrow). (C) Chest computed tomography scan showing a 52mm mass with necrosis on the manubrium of the sternum (arrow).

Mentions: A 76-year-old woman with a history of diabetes mellitus presented with memory disturbances that had begun 3 months prior. The patient was cooperative but could not recall recent memories. A physical examination revealed a 5 cm mass without tenderness in the sternum but no palpable masses were detected in the thyroid gland. The vital signs of the patient were stable and apart from the presence of hyperglycemia (serum glucose level, 510 mg/dL) the laboratory findings were all within normal limits. Brain magnetic resonance imaging (MRI) scans of the patient revealed a lobulated lesion in the right frontal lobe with a mixed signal core surrounded by a low intensity rim; the lesion was not enhanced in the contrast image. These particular MRI features are consistent with those of cavernous angioma with hemorrhage (Fig. 1A and 1B).


Solitary bone and brain metastasis in a patient with papillary thyroid carcinoma mimicking cavernous angioma
Radiological findings. (A) T1-weighted brain magnetic resonance image showing low mixed signal intensity (arrow). (B) T2-weighted image showing an isointense-to-hypointense lesion (arrow). (C) Chest computed tomography scan showing a 52mm mass with necrosis on the manubrium of the sternum (arrow).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5016272&req=5

f1-kjim-2014-321: Radiological findings. (A) T1-weighted brain magnetic resonance image showing low mixed signal intensity (arrow). (B) T2-weighted image showing an isointense-to-hypointense lesion (arrow). (C) Chest computed tomography scan showing a 52mm mass with necrosis on the manubrium of the sternum (arrow).
Mentions: A 76-year-old woman with a history of diabetes mellitus presented with memory disturbances that had begun 3 months prior. The patient was cooperative but could not recall recent memories. A physical examination revealed a 5 cm mass without tenderness in the sternum but no palpable masses were detected in the thyroid gland. The vital signs of the patient were stable and apart from the presence of hyperglycemia (serum glucose level, 510 mg/dL) the laboratory findings were all within normal limits. Brain magnetic resonance imaging (MRI) scans of the patient revealed a lobulated lesion in the right frontal lobe with a mixed signal core surrounded by a low intensity rim; the lesion was not enhanced in the contrast image. These particular MRI features are consistent with those of cavernous angioma with hemorrhage (Fig. 1A and 1B).

View Article: PubMed Central - PubMed

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

In particular, brain metastasis is very rare and is reported in only 1% of patients with thyroid carcinoma... The final pathological diagnosis was metastatic columnar cell-variant PTC, which is a very rare variant... The present patient was diagnosed with the columnar cell variant, which is characterized by pseudostratified columnar cells and subnuclear vacuolization that resembles early secretory endometrium... Although this PTC variant is very rare and only accounts for 0.15% to 0.2% of all PTCs, it is associated with aggressive behaviors such as a propensity for extrathyroidal extension, distant metastasis, and the death of the tumor... The prevalence of TgAb in thyroid malignancy patients is 10% to 30%, which is higher than among the normal population, and a high serum TgAb titer decreases after thyroid malignancy treatment while a sustained high serum TgAb titer could reflect early relapse... The survival rate of PTC patients significantly decreases when metastasis occurs... The common symptoms of patients with thyroid carcinoma and brain metastasis include headache, nausea, motor weakness, gait disturbances, sensory deficits, visual loss, and seizures but some patients with brain metastasis do not exhibit any symptoms and are only diagnosed with brain metastasis upon a postmortem examination... Due to the low incidence of brain metastatic PTC, a universal standard treatment protocol has yet to be established... However, the current treatment of choice is typically surgical resection because the removal of a brain metastasis significantly improves survival and is an independent predictor of better outcomes... Radiosurgery should be considered for patients who are unable to undergo surgery and whole brain radiation therapy can also be used to treat multiple metastases... Although brain radiation is not associated with a survival benefit, several cases have been reported indicating a regression of brain metastasis after such therapy... The present case was an extremely rare example of brain metastasis from columnar cell-variant PTC in which the brain metastatic lesion mimicked a cavernous angioma... These findings suggest that, depending on the PTC variant, even small PTCs should be treated with caution because they can lead to brain metastasis.

No MeSH data available.