Solitary Hemorrhagic Cerebellar Metastasis from Occult Papillary Thyroid Microcarcinoma

Lecumberri, Beatriz; Álvarez-Escolá, Cristina; Martín-Vaquero, Pilar; Nistal, Manuel; Martín, M.V.; Riesco‐Eizaguirre, Garcilaso; Sosa, Grevelyn; Pallardo, Luís Felipe

doi:10.1089/thy.2010.0062

Cited by 18 publications

(15 citation statements)

References 13 publications

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“…To date, only thirteen cases of CBM from PTC have been published ( Table 1 ) [ 1 – 12 ]. In agreement with previously reported cases, CBM cases in our series were seen during the sixth and seventh decades of life with mean age of 67 years (range: 64–72), and mean duration between initial diagnosis and CBM was 49.6 months (range: 37–61) [ 1 , 2 , 4 – 6 ]. In our series, one patient with aggressive variant of PTC (tall cell) was identified.…”

Section: Discussionsupporting

confidence: 92%

Cerebellum as Initial Site of Distant Metastasis from Papillary Carcinoma of Thyroid: Review of Three Cases

Tunio

Asiri

Al‐Qahtani

et al. 2015

Case Reports in Neurological Medicine

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Background. The cerebellum as initial site of distant metastasis from differentiated thyroid carcinoma (DTC) including papillary (PTC) and follicular thyroid carcinoma (FTC) is rare manifestation. Case Presentations. Herein, we present three cases of cerebellar metastasis (CBM) of PTC. Mean age of patients was 67 years (range: 64–72), and mean duration between initial diagnosis and CBM was 49.6 months (range: 37–61). Frequent location was left cerebellar hemisphere and was associated with hydrocephalus. All patients underwent suboccipital craniectomy, and in two patients postoperative intensity modulated radiation therapy (IMRT) was given to deliver 5000 cGy in 25 fractions to residual lesions. Patient without postoperative IMRT had cerebellar recurrence along with lung and bone metastasis after 38 months. However, two patients were found alive and free of disease at the time of last follow-up. Conclusion. CBM from PTC is a rare clinical entity and is often associated with hydrocephalus. Histopathological diagnosis is important to initiate effective treatment, which relies on multidisciplinary approach to prolong the disease-free and overall survival rates.

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Section: Discussionsupporting

confidence: 92%

Cerebellum as Initial Site of Distant Metastasis from Papillary Carcinoma of Thyroid: Review of Three Cases

Tunio

Asiri

Al‐Qahtani

et al. 2015

Case Reports in Neurological Medicine

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“…Only sporadic cases of hemorrhagic brain metastasis have been reported in association with papillary thyroid carcinoma. [10][11][12]15) The present case demonstrates that metastatic papillary thyroid carcinoma should be included in the differential diagnosis of solitary hemorrhagic tumor in the cerebellum. Early recognition of intracranial tumor should prompt immediate institution of a treatment plan.…”

Section: Discussionmentioning

confidence: 99%

“…By contrast, solitary hemorrhagic cerebellar metastasis from papillary thyroid carcinoma is extremely rare. [10][11][12]15) We describe a case of a patient with metastasis of papillary thyroid carcinoma to the cerebellopontine angle associated with intratumoral hemorrhage, which was initially misdiagnosed with simple cerebellar hemorrhage, resulting in delay of treatment.…”

Section: Introductionmentioning

confidence: 99%

Cerebellar Hemorrhage Secondary to Cerebellopontine Angle Metastasis From Thyroid Papillary Carcinoma

Tanaka

Kato

Aoki

et al. 2013

Neurol. Med. Chir.(Tokyo)

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A 63-year-old woman presented with a metastatic focus of papillary thyroid carcinoma in the cerebellopontine angle manifesting as lateral gazing nystagmus and slurred speech. Computed tomography demonstrated massive hemorrhage in the left cerebellar hemisphere. She was treated conservatively. Her symptoms resolved completely, but she experienced progressive deterioration in auditory acuity and ataxia over the next 6 months. Magnetic resonance imaging with gadolinium demonstrated an enhanced mass in the left cerebellopontine angle, and she was scheduled for elective resection of the tumor. Left retrosigmoid craniotomy was performed, and the tumor was subtotally removed except for a small amount at the junction of the trigeminal nerve and the pons. Histological examination confirmed a diagnosis of metastatic papillary thyroid carcinoma. The patient then underwent adjuvant gamma knife radiosurgery. Her clinical course was unremarkable, and her hypoacusis and ataxia resolved completely. Postoperative gallium scintigraphy revealed no residual tumor and no other systemic metastases. Hemorrhagic cerebellar metastasis from papillary thyroid carcinoma is extremely rare, but early recognition of metastatic cerebellar tumor should prompt immediate treatment to avoid the development of hearing loss, ataxia, and tonsillar herniation.

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“…Cerebellar metastases are even less common. Only 12 cases of metastatic changes in the cerebrum from DTC were reported in the literature, some of them occurring as solitary distant metastasis [2,3,[13][14][15][16][17]. The metastatic lesion in our patient was not solitary.…”

Section: Opis Przypadkumentioning

confidence: 60%

Przerzut do móżdżku raka brodawkowatego tarczycy wykryty w scyntygrafii receptorów somatostatynowych

Czepczyński

Wyszomirska

Gryczyńska

et al. 2018

Endokrynologia Polska

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Introduction: Distant metastases of papillary thyroid carcinoma (PTC) may lack the ability to concentrate radioiodine. In such cases, positive somatostatin receptor scintigraphy might be useful in demonstrating the expression of somatostatin receptors that are potential therapeutic targets. To date, only a few cerebellar metastases from PTC have been reported in the literature. Patient findings:We present an 82-year-old female, in whom an asymptomatic cerebellar metastasis from PTC was diagnosed by means of Tc-99m-EDDA/HYNIC-TOC scintigraphy four years after the initial diagnosis. She was previously treated with total thyroidectomy and regional lymph node dissection, followed by three cycles of radioiodine therapy. Despite persistently elevated thyroglobulin, no specific radioiodine accumulation was found in the whole body post-treatment scan. Tc-99m-EDDA/HYNIC-TOC scintiscan revealed foci of increased tracer uptake in the lungs, cervical lymph nodes, and a single focus in the head. Thus, therapy with octreotide LAR was initiated. The patient died four months later due to disseminated PTC. Summary: In this paper, a patient with asymptomatic previously unknown non-iodine avid cerebellar metastasis of PTC diagnosed by means of scintigraphy using somatostatin analogue Tc-99m-EDDA/HYNIC-TOC is reported. Conclusions: Somatostatin receptor scintigraphy might be useful in the visualisation of non-iodine avid PTC metastases and demonstrating the expression of somatostatin receptors that are potential therapeutic targets. (Endokrynol Pol 2018; 69 (1): 24-27)

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Solitary Hemorrhagic Cerebellar Metastasis from Occult Papillary Thyroid Microcarcinoma

Cited by 18 publications

References 13 publications

Cerebellum as Initial Site of Distant Metastasis from Papillary Carcinoma of Thyroid: Review of Three Cases

Cerebellum as Initial Site of Distant Metastasis from Papillary Carcinoma of Thyroid: Review of Three Cases

Cerebellar Hemorrhage Secondary to Cerebellopontine Angle Metastasis From Thyroid Papillary Carcinoma

Przerzut do móżdżku raka brodawkowatego tarczycy wykryty w scyntygrafii receptorów somatostatynowych

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