Shawky M, Proctor I, Kurzawinski T, Abdel-Aziz T
Centre for Endocrine Surgery, University College London Hospital, London, UK.
Department of General Surgery, Alexandria University, Alexandria, Egypt.
Ann R Coll Surg Engl. 2020 May;102(5):e107-e110. doi: 10.1308/rcsann.2020.0041. Epub 2020 Apr 1.
The brain is a particularly rare site of metastasis from papillary microcarcinoma, with only few cases described in the literature. We present a case of 59-year-old man who presented with seizures and dysphasia due to left frontal lobe cystic mass, which was excised and turned out on histopathology to be of thyroid origin. Total thyroidectomy was performed and histology showed multifocal papillary microcarcinoma with the largest focus of 3mm with no other adverse features. The patient had ablative radioactive iodine postoperatively, with subsequent exit scan showing no uptake in the brain. Follow-up brain magnetic resonance imaging showed continuous regression of the surgical cavity. Although rare, such cases should be aggressively treated and followed up over the long term, because of reported associated high mortality.
脑是甲状腺微小乳头状癌转移的一个特别罕见的部位，文献中仅有少数病例报道。我们报告一例59岁男性，因左额叶囊性肿块出现癫痫发作和吞咽困难，该肿块被切除，组织病理学检查结果显示其起源于甲状腺。患者接受了甲状腺全切术，组织学检查显示为多灶性甲状腺微小乳头状癌，最大病灶为3mm，无其他不良特征。患者术后接受了放射性碘消融治疗，随后的全身扫描显示脑部无摄取。随访的脑部磁共振成像显示手术腔持续缩小。尽管这种情况罕见，但由于据报道其相关死亡率较高，此类病例应积极治疗并长期随访。
