Hashimoto Leo, Watanabe Shiro, Majigsuren Mungunkhuyag, Hirata Kenji, Takenaka Junki, Kimura Rina, Ishii Hiroshi, Kudo Kohsuke
Department of Nuclear Medicine, Hokkaido University Hospital, Sapporo, Japan.
Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan.
Asia Ocean J Nucl Med Biol. 2025;13(2):208-212. doi: 10.22038/aojnmb.2025.86276.1618.
Brain metastasis (BM) occurs only in about 1% of differentiated thyroid carcinoma (DTC) cases. Although DTC generally has a good prognosis, once BM develops, the mortality rate significantly increases up to 78%. BM is usually treated by surgical resection or external radiotherapy, whereas radioactive iodine therapy (RAIT) using I-131 is much less often chosen because BM often shows poor uptake of I-131. In addition, even in case I-131 accumulates in the BM, RAIT could cause adverse effects such as brain hemorrhage and cerebral edema. We present a case of BM from DTC that showed response to I-131 therapy with no severe adverse effects. The brain lesion was very small and asymptomatic, and was only found after a post-therapy I-131 scintigraphy. There are a few case reports where BM was cured by RAIT with little to no side effects. We theorize that BM that is small in size, asymptomatic and show I-131 accumulation could be successfully treated with RAIT.
脑转移（BM）仅发生在约1%的分化型甲状腺癌（DTC）病例中。尽管DTC总体预后良好，但一旦发生BM，死亡率会显著上升至78%。BM通常通过手术切除或外照射放疗进行治疗，而使用I - 131的放射性碘治疗（RAIT）则较少被选用，因为BM往往对I - 131摄取不佳。此外，即使I - 131在BM中蓄积，RAIT也可能导致脑出血和脑水肿等不良反应。我们报告一例来自DTC的BM病例，该病例对I - 131治疗有反应且无严重不良反应。脑部病变非常小且无症状，仅在治疗后I - 131闪烁扫描时才被发现。有一些病例报告显示BM通过RAIT治愈且几乎没有副作用。我们推测，体积小、无症状且显示I - 131蓄积的BM可以通过RAIT成功治疗。
