Intracranial Metastasis from Thyroid Cancer : A Clinical Series with Review of the Literature |
Tae-Min Choi, Kyung-Sub Moon, Yeong-Jin Kim, Kyung-Hwa Lee, In-Young Kim, Shin Jung |
Department of Neurosurgery, Kwangju Christian Hospital, Nam-gu, Gwangju, Korea Department of Neurosurgery and Pathology, Chonnam National University Research Institute of Medical Sciences, |
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Abstract |
Objective In the present study, we aimed to elucidate the incidence of brain metastasis (BM) from thyroid cancer and sought
to review the cases to identify the clinical characteristics and compare intraparenchymal metastasis with extraparanchymal metastasis in terms of survival rates.
Materials & Methods: From a total of 9084 thyroid cancer patients who were diagnosed and treated at Chonnam National University Hwasun Hospital (CNUHH) between 1996 and 2012, 11 (0.12%) were retrospectively confirmed as having brain metastases from thyroid cancer. To define the clinical characteristics of the patients with brain metastases from thyroid cancer, clinical
data at the time of the diagnosis of brain metastases, including age, sex, presenting symptoms, histopathology, time interval
from the diagnosis of the primary tumor to the BM, Karnofsky performance status (KPS) score, thyroglobulin levels, treatment
modality, number of brain lesions, and survival time were collected.
Results The median time interval between the diagnosis of thyroid cancer and that of brain metastases was 38 months (range,
0–1370 months). Eight patients underwent surgical resection (73%) and two underwent only gamma knife radiosurgery (18%).
One patient received palliative medical treatment, mainly steroids. Patients with only extraparenchymal lesions had better outcomes and longer median survival times than those with only intraparenchymal lesions (52.3±34.2 vs. 8.6±4.7 months,
p=0.007). The histopathology of thyroid cancer in patients with only extraparenchymal metastases was mainly follicular carcinoma (80%), whereas the most common histopathology in patients with intraparenchymal metastases was papillary carcinoma.
Conclusion Extraparenchymal metastatic thyroid tumors showed better survival rates than intraparenchymal metastatic thyroid
tumors. This may have been due to their location that allows earlier detection, thereby improving their survival rates. |
Key Words:
Intracranial metastasis, Thyroid cancer, Prognosis. |
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