Parker L N, Wu S Y, Kim D D, Kollin J, Prasasvinichai S
Arch Intern Med. 1986 Oct;146(10):1985-7.
Papillary-follicular thyroid carcinoma usually remains localized to the thyroid bed and, in cases of metastasis, almost always involves the lung, bone, or liver. The two patients described here presented with papillary carcinoma and neurologic dysfunction. Total body iodine 131 scans disclosed cerebral uptake, and cerebral masses were confirmed by computed tomographic scan. Both patients presented diagnostic and therapeutic dilemmas, and ultimately underwent craniotomy. One patient's cerebral metastasis recurred and was treated by a second craniotomy. The other patient received postoperative external cerebral radiotherapy and a novel intraoperative treatment: implantation of 22 iodine 125 seeds in the tumor bed, estimated to yield 16,000 rad (160 Gy) in one year. To date, cerebral metastases have not recurred in the latter patient, although tumor has reappeared in other sites. There is little reported in the medical literature concerning cerebral metastases of thyroid carcinoma, and the present report reviews this experience and discusses treatment alternatives.
乳头状滤泡状甲状腺癌通常局限于甲状腺床，发生转移时，几乎总是累及肺、骨或肝。这里描述的两名患者表现为乳头状癌和神经功能障碍。全身碘131扫描显示脑部有摄取，脑部肿块经计算机断层扫描得以证实。两名患者均面临诊断和治疗难题，最终都接受了开颅手术。其中一名患者的脑转移复发，再次接受了开颅手术。另一名患者术后接受了脑部外照射放疗以及一种新型术中治疗：在瘤床植入22颗碘125粒子，估计一年可产生16000拉德（160戈瑞）的剂量。迄今为止，后一名患者的脑转移未复发，不过其他部位出现了肿瘤复发。医学文献中关于甲状腺癌脑转移的报道很少，本报告回顾了这一经验并讨论了治疗方案。
