Matsuno Akira, Katakami Hideki, Okazaki Ryo, Yamada So, Sasaki Mitsuyoshi, Nakaguchi Hiroshi, Yamada Shoko M, Hoya Katsumi, Murakami Mineko, Yamazaki Kazuto, Ishida Yasuo, Iwasaki Hiroyuki, Kuyama Jyunpei, Kakudo Kennichi
Department of Neurosurgery, Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan.
Neurol Med Chir (Tokyo). 2010;50(5):421-5. doi: 10.2176/nmc.50.421.
A 58-year-old woman and a 71-year-old woman presented with extremely rare skull base metastases from follicular thyroid carcinoma (FTC). Surgical removal and external radiotherapy were performed followed by iodine-131 ((131)I) brachytherapy and thyroid hormone administration. The metastatic tumors in the skull base were well controlled. Treatment for skull base metastasis from FTC includes surgical debulking of the metastatic lesion, as well as complete resection of the thyroid gland, followed by internal irradiation with (131)I, external irradiation, and administration of thyroid hormone to prevent tumor growth by suppression of endogenous thyroid-stimulating hormone. Skull base metastases may be the initial clinical presentation of FTC, with silent primary sites. The possibility of skull base metastasis from FTC should be considered in patients with clinical symptoms of cranial nerve dysfunction and radiological findings of bone destruction.
一名58岁女性和一名71岁女性因滤泡性甲状腺癌(FTC)出现极为罕见的颅底转移。进行了手术切除和外照射放疗,随后进行碘-131(¹³¹I)近距离放疗并给予甲状腺激素。颅底的转移瘤得到了良好控制。FTC颅底转移的治疗包括手术切除转移病灶,以及完整切除甲状腺,随后进行¹³¹I内照射、外照射,并给予甲状腺激素以通过抑制内源性促甲状腺激素来预防肿瘤生长。颅底转移可能是FTC的首发临床表现,原发部位隐匿。对于有颅神经功能障碍临床症状和骨质破坏影像学表现的患者,应考虑FTC颅底转移的可能性。