A large variety of metastatic tumors can be found in the skull; breast, prostate, lung carcinoma, multiple myeloma, neuroblastoma and sarcoma are among those that have been reported in the literature. In the current case, a very rare case of metastasis to skull from papillary thyroid carcinoma is reported. A 45-year-old man was admitted to our service with head trauma. Computed tomography and magnetic resonance imaging revealed lytic mass lesions in the right frontal and occipital bone extending through the dura mater and subcutaneous tissue. Right frontal, suboccipital craniectomy, tumor excision were performed and microscopic examination revealed papillary thyroid carcinoma metastasis. There is no consensus on treatment protocols for patients with central nervous system metastases from papillary thyroid carcinoma, most likely because of the rarity of cases. In the present case, we suggest that the best option for treatment of papillary thyroid carcinoma metastasis to skull would be surgery followed by radiotherapy. Pam Med J 2013;6(2):104-106Key words: Brain tumors, Craniotomy, Metastasis, Papillary Thyroid Carcinoma ÖzetKranial bölgeye bir çok farklı tümör metastaz yapabilmektedir; bunlar içerisinde meme, prostat, akciğer kanseri, multipl myeloma, nöroblastoma ve sarkoma sayılabilir. Bu yazıda çok nadir görülen papiller tiroid karsinomunun kraninuma metastazı sunulacaktır. 45 yaşında erkek hasta kafa travması şikayeti ile kliniğimize başvurdu. Çekilen kranial tomografi ve magnetik rezonans incelemelerinde sağ frontal ve oksipital kemikte dura mater ve subkutanöz dokulara uzanım gösteren litik kitle lezyonları tespit edildi. Çok nadir görülmesi nedeni ile papiller tiroid karsinomunun santral sinir sistemi metastazının tedavisi ile ilgili literatürde net bir tedavi şeması bulunmamaktadır. Bu yazı ile papiller tiroid karsinomunun kranial metastazında en uygun tedavi yönteminin cerrahi rezeksiyon ve ardından radyoterapi uygulaması şeklinde olduğu belirtilmiştir.
Dural based sarcoma is a rare aggressive neoplasm arising from the multipotent primitive mesenchymal stem cells of the dura. A 61-year-old male patient presented with complaints of loss of visual acuity in his right eye for 1 week. Neuroimaging revealed a tumour located at the right temporal lobe. The mass was dural-based. Three years ago dural based lesion was seen. In that period radiological diagnosis was meningioma. Within three years, the lesion has grown and radiologically presumed meningioma view has been disappeared. After surgical resection of the mass pathological diagnosis of primary dural based sarcoma was made. As in soft tissue sarcomas, diagnosis is mainly based on light microscopy, while immunohistochemistry can improve accuracy of diagnosis. In this article we would like to highlight two things: one is dural sarcoma and meningioma cannot be distinguished radiologically, and the other is the patient's three-year history.
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