Kurokawa Yasuharu, Ikawa Fusao, Hamasaki Osamu, Hidaka Toshikazu, Chikuie Hidekazu, Onuma Hideyuki
Department of Neurosurgery, Shimane Prefectural Central Hospital, Izumo-City, Shimane, Japan.
No Shinkei Geka. 2012 Nov;40(11):973-7.
We report a case of a brain metastasis of thyroid papillary carcinoma. A 67-year-old man had undergone a radical operation for thyroid papillary carcinoma 6 years before. He had no neurological deficit, but CT showed an enhanced lesion in the left frontal lobe. He underwent gamma knife radiosurgery. Four months later, the lesion with massive peritumoral edema was identified on magnetic resonance imaging (MRI). The edema was treated medically, however, recovery was seen neither on MRI nor clinically. Then left craniotomy was performed, with total resection of the tumor. During the operation Komai's stereotactic instruments were used for CT guided stereotactic surgery. Histopathological analysis of the surgical specimen confirmed mixed necrosis and papillary carcinoma of the thyroid gland. The patient was discharged without neurological deficit and is now kept under observation as an outpatient. Brain metastases from thyroid cancer are rare and we report a case of resection of brain metastasis of a thyroid papillary carcinoma after gamma knife radiosurgery.
我们报告一例甲状腺乳头状癌脑转移病例。一名67岁男性6年前曾接受甲状腺乳头状癌根治手术。他没有神经功能缺损，但CT显示左额叶有强化病灶。他接受了伽玛刀放射外科治疗。四个月后，磁共振成像（MRI）发现病灶伴有大量瘤周水肿。对水肿进行了药物治疗，但MRI及临床均未见恢复。随后进行了左开颅手术，肿瘤全切。手术过程中使用小牧立体定向器械进行CT引导下立体定向手术。手术标本的组织病理学分析证实为甲状腺混合性坏死及乳头状癌。患者出院时无神经功能缺损，目前作为门诊病人接受观察。甲状腺癌脑转移罕见，我们报告一例伽玛刀放射外科治疗后甲状腺乳头状癌脑转移灶切除病例。
