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Brain metastases from papillary thyroid carcinomas

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Abstract

Brain metastasis from papillary thyroid carcinoma (PTC) is extremely rare and carries a poor prognosis. We report nine cases (five females and four males) of brain metastasis of PTC. The age of patients ranged from 46 to 87 years old. The patients presented with nonspecific symptoms such as headaches. Brain metastasis was the first clinical presentation in three of nine patients; two of which had the aggressive tall cell variant of PTC. Six patients had prior history of PTC (four classic, one oncocytic variant, and one columnar cell variant) for 2 to 17 years with a median of 12 years. Gross total resection of brain metastasis was achieved for eight of our patients. Eight patients were treated with radioactive iodine. The median follow-up time was 12 months, ranging from 1 month to 4 years. Three patients died of their disease in 6 months, 21 months and 4 years, respectively after their first presentation of brain metastasis. It seems that these rare aggressive variants of PTC, such as tall cell variant, not only have higher propensity to develop brain metastasis, but also more frequently present with brain metastasis as their first clinical presentation than classic PTC. Furthermore, patients with PTC can develop brain metastasis even after many years.

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Acknowledgments

Cases 6–8 were presented as a poster at the 2008 American Association of Neuropathologist Annual Meeting at San Diego, California. Case 4 was published as a case report in Clinical Nuclear Medicine 35(5):357–359, 2010.

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Pathology and Laboratory Medicine, North Shore–Long Island Jewish Health System, Hofstra North Shore–LIJ School of Medicine 6 Ohio Drive, Suite 202, Lake Success, NY, 11042, USA

    Farnaz C. Tahmasebi, Peter Farmer & Jian Yi Li

  2. Department of Pathology, The Methodist Hospital, Houston, TX, USA

    Suzanne Z. Powell

  3. Department of Pathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA

    Kenneth D. Aldape & Gregory N. Fuller

  4. Department of Radiology, North Shore University Hospital, Manhasset, NY, USA

    Shital Patel

  5. Department of Neurosurgery, North Shore University Hospital, Manhasset, NY, USA

    Peter Hollis, David Chalif & Mark B. Eisenberg

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  1. Farnaz C. Tahmasebi
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  2. Peter Farmer
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  3. Suzanne Z. Powell
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Correspondence to Jian Yi Li.

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Tahmasebi, F.C., Farmer, P., Powell, S.Z. et al. Brain metastases from papillary thyroid carcinomas. Virchows Arch 462, 473–480 (2013). https://doi.org/10.1007/s00428-013-1394-4

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  • DOI: https://doi.org/10.1007/s00428-013-1394-4

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