Esmaeilzadeh Majid, Atallah Oday, Müller Jörg Andreas, Bengel Frank, Polemikos Manolis, Heissler Hans E, Krauss Joachim K
Department of Neurosurgery, Hannover Medical School, 30625 Hannover, Germany.
Department of Nuclear Medicine, Hannover Medical School, 30625 Hannover, Germany.
Cancers (Basel). 2024 Jun 28;16(13):2371. doi: 10.3390/cancers16132371.
Intracranial metastases from thyroid cancer are rare. Although the prognosis of thyroid cancer patients is generally favorable, the prognosis of patients with intracranial metastases from thyroid cancer has been considered unfavorable owing to lower survival rates among such patients compared to those without intracranial involvement. Many questions about their management remain unclear. The aim of the present study was to analyze the characteristics, treatment modalities, and outcomes of patients with brain metastases from thyroid cancer. Among 4320 patients with thyroid cancer recorded in our institutional database over a 30-year period, the data of 20 patients with brain metastasis were retrospectively collected and analyzed. The clinical characteristics, histological type of primary cancer and metastatic brain tumor, additional previous distant metastasis, treatment modalities, locations and characteristics on radiologic findings, time interval between the first diagnosis of primary thyroid cancer and brain metastasis, and survival were analyzed. Among our patient cohort, the mean age at initial diagnosis was 59.3 ± 14.1 years, and at the manifestation of diagnosis of cerebral metastasis, the mean age was found to be 64.8 ± 14.9 years. The histological types of primary thyroid cancer were identified as papillary in ten patients, follicular in seven, and poorly differentiated carcinoma in three. The average interval between the diagnosis of thyroid cancer and brain metastasis was 63.4 ± 58.4 months (range: 0-180 months). Ten patients were identified as having a single intracranial lesion, and ten patients were found to have multiple lesions. Surgical resection was primarily performed in fifteen patients, and whole-brain radiotherapy, radiotherapy, or tyrosine kinase inhibitors were applied in the remaining five patients. The overall median survival time was 15 months after the diagnosis of BMs from TC (range: 1-252 months). Patients with thyroid cancer can develop brain metastasis even many years after the diagnosis of the primary tumor. The results of our study demonstrate increased overall survival in patients younger than 60 years of age at the time of diagnosis of brain metastasis. There was no difference in survival between patients with brain metastasis from papillary carcinoma and those with follicular thyroid carcinoma.
甲状腺癌的颅内转移很少见。尽管甲状腺癌患者的预后总体良好，但由于与无颅内转移的患者相比，甲状腺癌颅内转移患者的生存率较低，因此这类患者的预后一直被认为不佳。关于其治疗的许多问题仍不明确。本研究的目的是分析甲状腺癌脑转移患者的特征、治疗方式和预后。在我们机构数据库中记录的30年间的4320例甲状腺癌患者中，回顾性收集并分析了20例脑转移患者的数据。分析了临床特征、原发性癌和转移性脑肿瘤的组织学类型、既往是否有其他远处转移、治疗方式、影像学检查结果的部位和特征、原发性甲状腺癌首次诊断与脑转移之间的时间间隔以及生存率。在我们的患者队列中，初次诊断时的平均年龄为59.3±14.1岁，脑转移诊断时的平均年龄为64.8±14.9岁。原发性甲状腺癌的组织学类型确定为乳头状癌10例，滤泡状癌7例，低分化癌3例。甲状腺癌诊断与脑转移之间的平均间隔时间为63.4±58.4个月（范围：0 - 180个月）。10例患者被确定为单一颅内病变，10例患者有多个病变。15例患者主要接受了手术切除，其余5例患者接受了全脑放疗、放疗或酪氨酸激酶抑制剂治疗。甲状腺癌脑转移诊断后的总体中位生存时间为15个月（范围：1 - 252个月）。甲状腺癌患者即使在原发性肿瘤诊断多年后也可能发生脑转移。我们的研究结果表明，脑转移诊断时年龄小于60岁的患者总体生存率有所提高。乳头状癌脑转移患者与滤泡状甲状腺癌脑转移患者的生存率没有差异。
