Fujita Takeo, Ogasawara Yutaka, Doihara Hiroyoshi
Department of Cancer and Thoracic Surgery, Okayama University School of Medicine, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan.
Surg Today. 2009;39(1):44-7. doi: 10.1007/s00595-008-3783-x. Epub 2009 Jan 8.
Thyroid cancers rarely metastasize to the brain: the incidence of brain metastasis of differential thyroid carcinomas has been reported at only 0.69%-1.3%. We report a case of a solitary brain metastasis from thyroid follicular carcinoma found 13 years after primary surgery. A 73-year-old woman was admitted to our hospital for investigation of headaches, double vision, and facial nerve palsy, 13 years after a subtotal thyroidectomy for thyroid follicular carcinoma. Magnetic resonance imaging (MRI) showed a solitary mass in the midbrain associated with a focal osteolytic lesion of the temporal bone. Further radiological examinations revealed no other mass lesion. After making a provisional preoperative diagnosis of a primary brain tumor, we performed subtotal removal of the tumor. Histopathological examination confirmed metastasis of thyroid follicular carcinoma. Thus, the patient underwent completion thyroidectomy followed by internal radiotherapy. She has remained well in the 4 years since her operation, without any signs of further recurrence.
不同类型甲状腺癌的脑转移发生率仅报道为0.69%-1.3%。我们报告1例甲状腺滤泡癌原发手术后13年发现的孤立性脑转移病例。一名73岁女性因甲状腺滤泡癌行甲状腺次全切除术后13年,因头痛、复视和面神经麻痹入院我院检查。磁共振成像(MRI)显示中脑有一个孤立性肿块,伴有颞骨局灶性溶骨性病变。进一步的影像学检查未发现其他肿块病变。在术前初步诊断为原发性脑肿瘤后,我们对肿瘤进行了次全切除。组织病理学检查证实为甲状腺滤泡癌转移。因此,患者接受了甲状腺全切术,随后进行了内照射放疗。自手术以来的4年里,她情况良好,没有任何进一步复发的迹象。