Abstract
Brain metastasis of differentiated thyroid cancer (DTC) often is detected during treatment of other remote lesions. We examined the prevalence, risk factors and treatment outcome of this disease encountered during nuclear medicine practice. Of the 167 patients with metastasis to lung or bone treated 1–14 times with radioactive iodine (RAI), 9 (5.4%) also had lesions in the brain. Five were males and 4 females, aged 49–84, out of the original population of 49 males and 118 females aged 10–84 (mean 54.7) years. Three of them underwent removal of their brain tumors, 5 received conventional external beam irradiation, and 2 had stereotactic radiosurgery with supervoltage X-ray. None of the brain lesions showed significant uptake of RAI despite demonstrable accumulation in most extracerebral lesions. Seven patients died 4–23 (mean 9.4) months after the discovery of cerebral metastasis, brain damage being the primary or at least a contributing cause. The 8th and 9th patients remained relatively well for more than 42 and 3 months, respectively, without any evidence of intracranial recurrence. Our results confirmed that the brain is a major site of secondary metastasis from DTC. No statistically significant demographic risk factor was detected. Any suspicious neurological symptoms in the course of RAI treatment warrant cerebral computed tomography. As for therapy, from our initial experience, radiosurgery seemed promising as an effective and less invasive alternative to surgical removal.
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Venkatesh S, Leavens ME, Samaan NA. Brain metastases in patients with well-differentiated thyroid carcinoma: study of 11 cases.Eur J Surg Oncol 16: 448–450, 1990.
Salvati M, Cervoni L, Celli P. Solitary brain metastases from thyroid carcinoma: study of 6 cases.Tumori 81: 142–143, 1995.
Chiu AC, Delpassand ES, Sherman SI. Prognosis and treatment of brain metastases in thyroid carcinoma.J Clin Endocrinol Metab 82: 3637–3642, 1997.
Kasagi K, Misaki T, Alam S, Konishi J. Radioiodine treatment for thyroid cancer.Thyroidol Clin Exp 10: 115–120, 1998.
Leksell L. The stereotactic method and radiosurgery of the brain.Acta Chir Scan 102: 316–319, 1951.
Sturm V, Kober B, Höver K-H, Schlegel W, Boesecke R, Pastyr O, et al. Stereotactic percutaneous single dose irradiation of brain metastases with a linear accelerator.Int J Radiat Oncol Biol Phys 13: 279–282, 1987.
Marquet P-V, Daver A, Sapin R, Bridgi B, Muratet J-P, Hartmann DJ, et al. Highly sensitive immunoradiometric assay for serum thyroglobulin with minimal interference from autoantibodies.Clin Chem 42: 258–262, 1996.
Carcangiu ML, Zampi G, Pupi A, Castagnoli A, Rosai J. Papillary carcinoma of the thyroid: A clinicopathologic study of 241 cases treated at the University of Florence, Italy.Cancer 55: 805–828, 1985.
Høie J, Stenwig AE, Kullmann G, Lindegaard M. Distant metastases in papillary thyroid cancer.Cancer 61: 1–6, 1988.
Dinneen SF, Valimaki MJ, Bergstralh EJ, Goellner JR, Gordman CA, Hay ID. Distant metastases in papillary thyroid carcinoma: 100 cases observed at one institution during 5 decades.J Clin Endocrinol Metab 80: 2041–2045, 1995.
Parker LN, Wu S-Y, Kim DD, Kollin J, Prasasvinichai S, Recurrence of papillary thyroid carcinoma presenting as a focal neurologic deficit.Arch Intern Med 146: 1985–1987, 1986.
Mendenhall WM, Friedman WA, Bova FJ. Linear accelerator-based stereotactic radiosurgery for acoustic schwannomas.Int J Radiat Oncol Biol Phys 28: 803–810, 1994.
Betti OO, Munari C, Rosler R. Stereotactic radiosurgery with the linear accelerator: treatment of arteriovenous malformations.Neurosurgery 24: 311–321, 1989.
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Misaki, T., Iwata, M., Kasagi, K. et al. Brain metastasis from differentiated thyroid cancer in patients treated with radioiodine for bone and lung lesions. Ann Nucl Med 14, 111–114 (2000). https://doi.org/10.1007/BF02988589
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DOI: https://doi.org/10.1007/BF02988589