Portocarrero-Ortiz Lesly, Garcia-Lopez Rabindranath, Romero-Vargas Samuel, Padilla Javier Avendaño-Mendez, Gómez-Amador Juan L, Salinas-Lara Citlaltépetl, Tena-Suck Martha Lilia, González Arturo Sotomayor
Department of Endocrinology, Instituto Nacional de Neurologia y Neurocirugia "Manuel Velazco Suarez", Insurgentes Sur 3877 Col. La Fama, Tlalpan, C.P. 14269, Mexico City, D.F., Mexico.
Department of Neurosurgery, Instituto Nacional de Neurologia y Neurocirugia "Manuel Velazco Suarez", Mexico City, Mexico.
J Neurooncol. 2009 Nov;95(2):281-284. doi: 10.1007/s11060-009-9915-3. Epub 2009 May 17.
Follicular thyroid cancer rarely manifests itself as a distant metastatic lesion. We report a case of a 61-year-old woman presented with a solid mass located in the left temporo-occipital region. The 3D computed tomography showed a large solid mass with high vascularity, skull erosion and supra-infratentorial epidural mass effect. After magnetic resonance imaging (MRI) a suspect diagnosis of meningioma was made. The patient underwent surgery where a soft mass with transverse sinus invasion was encountered, the tumor was successfully resected employing microsurgical techniques. Histological examination revealed a thyroid follicular neoplasm with positive staining for follicular carcinoma in immunohistochemical analysis. Postoperatively levels of thyroid hormones were normal. Treatment was planned for the thyroid gland, but the patient did not consent. The present case emphasizes that although they are uncommon, dural metastasis can be mistaken for meningiomas. The definitive diagnosis of a meningioma should be established only after the histopathological analysis. Thyroid follicular carcinoma should be included in the differential diagnosis in cases of extrinsic tumoral lesions.
滤泡状甲状腺癌很少表现为远处转移病灶。我们报告一例61岁女性，其左侧颞枕部出现一个实性肿块。三维计算机断层扫描显示一个大的实性肿块，血管丰富，颅骨侵蚀，幕上幕下硬膜外肿块效应。经磁共振成像（MRI）后，初步诊断为脑膜瘤。患者接受手术，术中发现一个侵犯横窦的软肿块，采用显微外科技术成功切除肿瘤。组织学检查显示为甲状腺滤泡性肿瘤，免疫组化分析显示滤泡癌染色阳性。术后甲状腺激素水平正常。计划对甲状腺进行治疗，但患者不同意。本病例强调，虽然硬脑膜转移不常见，但可能被误诊为脑膜瘤。只有在组织病理学分析后才能确立脑膜瘤的明确诊断。在出现外在肿瘤性病变的病例中，甲状腺滤泡癌应列入鉴别诊断。
