Choroid Plexus Metastasis of Follicular Thyroid Carcinoma Diagnosed due to Intraventricular Hemorrhage

Abstract

Choroid plexus metastasis (CPM) is extremely rare and originates most frequently from renal cell carcinoma (RCC). We herein report the case of a 58-year-old man who developed a solitary CPM lesion derived from follicular thyroid carcinoma in addition to intraventricular hemorrhage. Computed tomography revealed acute hydrocephalus as a result of the hemorrhage, and we planned endoscopic hematoma evacuation. Since it was too difficult to reach the hematoma, we considered the possibility of a neoplasm and performed a biopsy of the lesion, the results of which led to an accurate diagnosis of CPM in this case. We also review previous reports of CPM originating from thyroid carcinoma compared with RCC.

Multifocal metastases to choroid plexus from papillary thyroid carcinoma: illustrative case

“…6 Thyroid carcinoma metastasizes to the brain in only 0.9%-1.5% of cases and has been reported in the CP in eight prior cases. 1,[5][6][7][8][9][10][11] Of the nine total cases, this is only the second involving multifocal CP lesions. 1,[5][6][7][8][9][10][11] Metastatic spread to the CNS in general is a sign of end-stage disease, but with limited reports of thyroid carcinoma metastatic to the CP, prognostication for this diagnosis is difficult.…”

“…1,[5][6][7][8][9][10][11] Of the nine total cases, this is only the second involving multifocal CP lesions. 1,[5][6][7][8][9][10][11] Metastatic spread to the CNS in general is a sign of end-stage disease, but with limited reports of thyroid carcinoma metastatic to the CP, prognostication for this diagnosis is difficult. This case is thus a rare presentation of a rare entity with a markedly poor outcome; the patient had a rapid decline and survived a little more than 2 months from the time CP metastases were diagnosed.…”

“…Table 1 summarizes key points from the eight previously reported cases of CP metastases from DTC to identify other potential prognostic indicators. 1,[5][6][7][8][9][10][11] Patients in the cases with the two worst outcomes had clinical and radiographic evidence of hydrocephalus, one of which was complicated by IVH. 6,7 Overall, IVH was present in four of the cases, with hydrocephalus present in at least three.…”

“…[1][2][3][4] Eight cases of CP metastases from thyroid carcinoma have been reported previously, with only two confirmed cases of multifocal CP metastases known to date. 1,[5][6][7][8][9][10][11] All eight cases involved differentiated thyroid carcinoma (DTC), namely papillary or follicular subtypes. Only two known cases of multifocal metastasis to the CP from any malignancy exist in the literature, originating from papillary thyroid carcinoma and renal cell carcinoma, respectively.…”

Metastatic cerebellar tumor of papillary thyroid carcinoma mimicking cerebellar hemangioblastoma

“…There are no characteristics of MRI or other radiographic abnormalities that distinguish metastatic lesions of thyroid carcinoma from other brain tumors (McWilliams et al 2003 ; Tunio et al 2015 ). There are only three cases in which findings in digital subtraction angiography have been described (Cha et al 2000 ; Hashiba et al 2006 ; Umehara et al 2015 ). In each of these, relatively prominent-tumor staining with an apparent feeding artery was observed, and the consistency of these findings with those in our case suggest that a metastatic PTC lesion has a tendency to develop into a vascular-rich tumor bulk.…”