Korean Journal of Head & Neck Oncology (대한두경부종양학회지)

The Korean Society for Head and Neck Oncology (대한두경부종양학회)
권호 표지

Brain Metastases from Well-Differentiated Thyroid Carcinoma

뇌 전이 분화 갑상선암

  • Lee Jan-Dee (Department of Surgery, Yonsei University College of Medicine) ;
  • Yoon Jong-Ho (Department of Surgery, Yonsei University College of Medicine) ;
  • Chang Hang-Seok (Department of Surgery, Yonsei University College of Medicine) ;
  • Park Cheong-Soo (Department of Surgery, Yonsei University College of Medicine)
  • 이잔디 (연세대학교 의과대학 외과학교실) ;
  • 윤종호 (연세대학교 의과대학 외과학교실) ;
  • 장항석 (연세대학교 의과대학 외과학교실) ;
  • 박정수 (연세대학교 의과대학 외과학교실)
  • Published : 2004.05.01
Download PDF
⟨ Previous Next ⟩

Abstract

Background and Objectives: Brain metastasis from well-differentiated thyroid carcinoma is uncommon, and the treatment remains controversial. In this study, we analyzed cases of brain metastasis from well differentiated thyroid carcinoma to determine optimal treatment. Material and Methods: From March 1986 to May 2003, we experienced 13 cases of brain metastases from well-differentiated thyroid carcinomas. There were 6 men and 7 women with a mean age of 62.3 years. The time interval detecting the brain metastasis, treatment methods, outcomes, and the prognostic factors were analyzed. Results: In 11 patients, brain metastasis was found at a mean of 96 months after thyroid surgery (range, 1-204months). In 1 patient, brain metastasis was found simultaneously with the thyroid cancer. In the remaining one, brain metastasis was presented as the first sign. Treatment included gamma knife therapy in 2, external radiation therapy (ExRT) in 2, resection and ExRT in 2, gamma knife therapy and ExRT in 2 and intracranial holmium injection in 1. Three patients received no treatment. The mean survival was 20.5months (1-119 months). Only 2 patients with early detection remained alive after treatment (23months and 119months). The age, sex, primary tumor size, combined organs of distant metastasis and treatment methods did not affect the prognosis. There were noticeable symptomatic improvements in patients who received any kind of treatment for brain metastasis. Conclusion: Early detection and treatment of brain metastasis appears to bring symptomatic relief and improve survival. Therefore, early screening for brain metastasis is recommended for patients with symptoms. However, further study is needed to determine the optimal method of treatment.

Keywords

References

  1. Robert R McWilliams, Caterinal Giannini, Ian D Hay : Management of Brain metastases from thyroid cancer : A Study of 16 Pathologically Confirmed Cases over 25 Years. American Cancer Society. 2003 ; 98 : 356-362
  2. Hay ID : Brain metastases from papillary thyroid carcinoma, Arch Intern Med. 1987 ; 147 : 607-611
  3. Patchell RA, Tibbs PA, Regine WF : Postoperative radiotherapy in the treatment of single metastases to the brain : a randomized trial. JAMA. 1998 ; 80 : 1485-1489
  4. Parker LN, Wu SY Kim DD, Kollin J, et al : Recurrence of papillary thyroid carcinoma presenting as a focal neurologic deficit. Arch Intern Med. 1986 ; 146 : 1985-1987 https://doi.org/10.1001/archinte.146.10.1985
  5. Dinneen SF, Valimaki MJ, Bergstralh EJ, et al : Distant metastases in papillary thyroid carcinoma : 100 cases observed at one institution during 5 decades. J Clin Endocrinol Metab. 1995 ; 80 : 2041-2045 https://doi.org/10.1210/jc.80.7.2041
  6. Chiu AC, Delpassand ES, Sherman SI : Prognosis and treatment of brain metastases in thyroid carcinoma. J Clin Endocrinol Metab. 1997 ; 82 : 3637-3642 https://doi.org/10.1210/jc.82.11.3637
  7. Muacevic A, Kreth FW, Horstmann GA, et al : Surgery and radiotheray compared with gamma knife radiosurgery in the treatment of solitary cerebral metastases of small diameter. J Neurosurg. 1999 ; 91 : 35-43 https://doi.org/10.3171/jns.1999.91.1.0035
  8. Loeffler JS, Patchell RA, Sawaya R : Metastatic brain cancer : Principles and Practice of Oncology, Lipineott-Raven Publishers, Philadelphia. 1998 ; 2523-2536
  9. Patchell RA, Tibbs PA, Walsh JW, et al : A rand-omized trial of surgery in the treatment of single metastases to the brain. N Engl J Med. 1990 ; 322 : 494-500 https://doi.org/10.1056/NEJM199002223220802
  10. Jeong GA, Kim KC, Kim DH, et al : Brain metastasis from papillary carcinoma of the thyroid. J Ko-rean Surg Soc. 2003 ; 64 : 505-509
  11. Pak H, Loukas Gorgiotis, Chang Sen-I, Lori C Guthrie: Role of Metastaectomy in the management of thyroid carcinoma : the NIH experience. J Surg Oncol. 2003 ; 82 : 10-18 https://doi.org/10.1002/jso.10189
  12. Jyothirmayi R, Edison J, Nayar PP, et al : Case report : Brain metastases from papillary carcinoma thyroid. Br J Radiol Suppl. 1995 ; 68 : 767-769 https://doi.org/10.1259/0007-1285-68-811-767
  13. Carcangju mL, Zampi G, Pupi A, et al : Papillary carcinoma of the thyroid ; A clinicopathologic study of 241 cases treated at the University of Florence, Italy. Cancer. 1985 ; 55 : 805-828 https://doi.org/10.1002/1097-0142(19850215)55:4<805::AID-CNCR2820550419>3.0.CO;2-Z
  14. Biswal BM, Bal CS, Sandhu MS, Padhy AK : Manangement of intracranial metastases of diffenentiated carcinoma of thyroid. Neuro-oncol. 1994 ; 22 : 77-81 https://doi.org/10.1007/BF01058357
  15. Bedikian AY, Valdivieso M, Heilburn LK, et al : A successful alternative to dexamethasone for patients receiving brain irradiation for metastatic disease. Cancer Treat Res. 1978 ; 62 : 1081-1086
  16. Hjiyiannakis P, Jefferies S, Harmer CL : Brain metastases in patients with differentiated thyroid carcinoma Clin Oneol. 1996 ; 8 : 327-330
  17. Cha ST, Reza Jarrahy, Ronald A Mathiesen, et al : Cerebellopontine Angle Metastasis from papillary carcinoma of the thyroid. Surg Neurol. 2000 ; 54 : 320-326 https://doi.org/10.1016/S0090-3019(00)00306-2
  18. Hoie J, Stenwig AE, kullmann G, Lindergaard M : Distant metastases in papillary thyroid cancer : a review of 91 patients, Cancer. 1988 ; 61 : 1-6