Metástasis en el lóbulo frontal como primera manifestación clínica de un carcinoma folicular de tiroides

Abstract

El carcinoma folicular de tiroides puede producir metástasis a distancia, siendo las localizaciones más habituales el pulmón y el hueso. Las metástasis cerebrales son inusuales, y es poco habitual que aparezcan como primera manifestación de cáncer. Caso clínico: Paciente varón de 80 años, que tras una caída al suelo comenzó con alteración del comportamiento, desorientación y pérdida del control de esfínteres. La tomografía computarizada cerebral evidenció una masa en el lóbulo frontal derecho. Se realizó la extirpación de la lesión cerebral, cuyo estudio histológico informó de metástasis de carcinoma folicular de tiroides. Conclusión: La manifestación de la enfermedad con metástasis cerebrales es muy infrecuente, y empeora el pronóstico notablemente.

Brain Metastasis of Follicular Thyroid Carcinoma in Pregnancy: A Case Report and Literature Review

“…BM in thyroid cancer patients has been associated with men, advanced age, large primary tumors, and evidence of extra thyroid invasion with the appearance of distant metastases, which makes the reported case even more rare because it is a pregnant, young woman, with no evidence of large primary tumor or other distant metastasis site [12]. The most frequent location of BM is in the cerebral hemispheres, as occurred in the patient in the report, although they may also appear in the pituitary and cerebellum [9].…”

“…However, although they are very similar, they behave differently. The follicular, subtype presented by the patient in the case, tends to be more aggressive, has higher mortality rates and is, more often, diagnosed in more advanced stages of the disease when compared with papillary carcinoma [9]. Still under this comparison, FTC is even more vascularized and, therefore, releases metastases more frequently, in a rate of 15%-27% of patients and the most affected sites are the bones and lungs [6].…”

“…The treatment of choice is surgical resection of metastasis followed by radiotherapy [9]. In this case, due to the circumstances of a neurological surgical emergency, it was decided to perform an emergency cesarean section concomitant with a decompressive craniectomy associated with excision of the tumor.…”