Ohta Yoshihisa, Chong Ja-Mun
Department of Neurosurgery, Tokyo Metropolitan Matsuzawa Hospital, 2-1-1 Kamikitazawa, Setagaya-ku, Tokyo 156-0057, Japan.
No Shinkei Geka. 2009 May;37(5):467-72.
We report a case of a brain metastasis of thyroid papillary carcinoma. A 50-year-old man suffered generalized convulsion. MRI showed a mixed intensity mass with a perifocal low intensity rim in T2WI, mimicking cavernous angioma. The patient underwent craniotomy and total removal of the mass. The resected specimen revealed thyroid papillary carcinoma. Further examination showed a mass in his thyroid gland. Other distant metastases were not revealed. This is a case of a solitary brain metastasis of thyroid papillary carcinoma and the patient's initial symptom was caused by brain metastasis. Such cases are extremely rare. The mass was presurgically diagnosed as a cavernous angioma but was actually a case of brain metastasis. If we had not performed mass removal, we would not have been able to diagnose it as brain metastasis from thyroid papillary carcinoma and would have not taken appropriate steps toward further examinations and treatment. We must manage carefully a mass resembling cavemous angioma in MRI in consideration of the possibility of its being another diseases such as a metastatic tumor.
我们报告一例甲状腺乳头状癌脑转移病例。一名50岁男性发生全身性惊厥。磁共振成像(MRI)显示在T2加权像上有一个混合强度肿块,其周围有低强度边缘,类似海绵状血管瘤。该患者接受了开颅手术并将肿块完全切除。切除的标本显示为甲状腺乳头状癌。进一步检查发现其甲状腺有一个肿块。未发现其他远处转移。这是一例甲状腺乳头状癌孤立性脑转移病例,患者的初始症状由脑转移引起。此类病例极为罕见。该肿块术前被诊断为海绵状血管瘤,但实际上是脑转移病例。如果我们没有进行肿块切除,就无法将其诊断为甲状腺乳头状癌脑转移,也无法采取进一步检查和治疗的适当措施。考虑到类似海绵状血管瘤的肿块可能是其他疾病如转移性肿瘤,我们必须谨慎处理MRI检查中类似海绵状血管瘤的肿块。