Rare Brain Metastasis From Papillary Thyroid Carcinoma at the Cerebellopotine Angle: a Case Report and Review of the Literature

罕見甲狀腺惡性乳突瘤合併小腦橋腦交界處轉移病例報告以及文獻回顧

10.6316/TRO/200108(1)61

游惟強(Weir-Chiang You)；詹建勝(Jian-Sheng Jan)

甲狀腺腫瘤 ； 惡性乳突瘤 ； 腦部轉移 ； 三度空間立體定位順形放射治療 ； Thyroid cancer ； Papillary carcinoma ； Intracranial metastasis ； 3D-conformal radiotherapy

放射治療與腫瘤學

8卷1期（2001 / 03 / 01）

61 - 65

英文

甲狀腺惡性乳突瘤是甲狀腺惡性腫瘤中最常見的一種病理型態，通常腫瘤生長速度和臨床進程緩慢。局部淋巴轉移並不常見。如果病理分期顯示有局部淋巴轉移，其局部復發率較高。其預後和年齡、腫瘤大小、性別、手術切除範圍，有無甲狀腺外侵犯、有無多病灶以及有無遠處轉移等因度有關。合併遠處轉移不常見，尤其腦部轉移相當少見。根據醫學文獻資料，腦部轉移約佔0.1-5%左右。在腦部轉移的病例中，轉移病灶最常見於兩側大腦半球。在此，我們報告一甲狀腺惡性乳突瘤合併左側小腦橋腦交界處轉移的罕見病例，成功的以合併手術切除腫瘤、手術後放射治療以及放射性碘治療的整合性療法治療，並且分享我們治療這病例的經驗。

Papillary thyroid carcinoma (PTC), representing the most common type of the thyroid cancer, is usually slow-growing and runs an indolent clinical course. Metastasis to regional lymph nodes is a common finding. Patients with initial N1 stage or higher have higher local recurrence rate. The prognosis had been related to the age at initial diagnosis, tumor size, sex, extent of surgical resection, presence of extrathyroid invasion, multi centricity and presence of distant metastasis [4]. Distant metastasis is uncommon, especially intracranial metastasis that is rare with a frequency of 0.1-5% in reported series Cerebral hemispheres are the most common site of intracranial metastasis in reported series. We report a case of papillary carcinoma of the thyroid with metastasis to a very unusual location of left cerebellopotine angle and present our experience of successful management for this case with combined modalities including surgery, post-operative adjuvant radiotherapy and radioiodine therapy. Literature reviews of this unusual clinical presentation are also discussed.