Wang Mawson, Samra Spinder, Chou Shaun, Howle Julie, Gild Matti L, Girgis Christian Meena
Department of Endocrinology and Diabetes Westmead Hospital Westmead New South Wales Australia.
Westmead Clinical School, School of Medicine The University of Sydney Sydney New South Wales Australia.
Clin Case Rep. 2022 Sep 2;10(9):e6207. doi: 10.1002/ccr3.6207. eCollection 2022 Sep.
Thyroid cancer is the most common endocrine cancer, with papillary thyroid carcinoma (PTC) accounting for the majority of these cases. Cerebellar metastasis is rarely the presenting feature and confers poor prognosis. Genetic mutations in this setting are most commonly , in contrast to in the majority of PTC. We report the case of an 82 year-old male who presented with a symptomatic right cerebellar lesion and underwent surgical resection to demonstrate metastatic PTC. Extensive workup with computed tomography, neck ultrasound and FDG-PET was suggestive of a left thyroid primary lesion, with FNA confirming PTC. However, total thyroidectomy demonstrated incidental microMTC (medullary thyroid microcarcinoma, defined as tumour <10mm) without any evidence of PTC, whereas the left level VI neck dissection demonstrated a 30mm nodule of PTC without identifiable normal thyroid or lymph node tissue.
甲状腺癌是最常见的内分泌癌，其中甲状腺乳头状癌（PTC）占大多数病例。小脑转移很少是首发特征，且预后较差。与大多数PTC不同，这种情况下的基因突变最常见的是 。我们报告了一例82岁男性病例，该患者出现有症状的右侧小脑病变，并接受了手术切除，结果显示为转移性PTC。通过计算机断层扫描、颈部超声和氟脱氧葡萄糖正电子发射断层扫描进行的全面检查提示左侧甲状腺有原发性病变，细针穿刺活检证实为PTC。然而，甲状腺全切术显示意外发现微小髓样甲状腺癌（髓样甲状腺微癌，定义为肿瘤<10mm），未发现任何PTC证据，而左侧VI区颈部淋巴结清扫显示一个30mm的PTC结节，未发现正常甲状腺或淋巴结组织。
