Late Metastases of Brain and Skull From Papillary Thyroid Carcinoma: A Case Report

Abstract

Brain metastases from papillary thyroid carcinoma (PTC) are extremely rare entities. Distant metastases are rare and usually occur in advanced stages of the disease. Such type of metastases almost always develop synchronously, particularly in the lungs, bones and thoracic lymph nodes. In this condition, poor prognosis has been shown and tumor behavior is more aggressive. We present a case of papillary thyroid carcinoma (PTC) with late skull and brain metastases emerged 20 years after the primary disease. The patient is a 57-year-old woman who presented with urinary incontinence, left hemiparesia, and memory loss. The patient had undergone surgery in 1987 for tyroid malignancy, and three operations for an intracranial meningioma in 1988, 1992 and 1995. Therefore, a computed tomography (CT) and magnetic resonance imaging (MRI) were performed on the patient. CT and MRI revealed two masses located on the right and left frontal poles. The patient underwent total excision of the recurrent intracranial meningioma, but histopathologic diagnosis was determined as PTC. Patient was treated with radioactive iodine 131 following craniocervical surgery.