Abstract
Background
Intracranial metastasis from thyroid cancer is extremely rare. However, less is known about the risk factors for intracranial metastasis and its treatment from few retrospective studies. The aim of this study was to contribute to the understanding of this disease by analyzing patients with intracranial metastases from thyroid cancer.
Methods
Between 2001 and 2014, the database of the National Cancer Center of Korea was searched for thyroid cancer patients. The clinical characteristics and site of distant metastasis according to the histological type were evaluated in the thyroid cancer cohort. Among the patients with intracranial metastases, the characteristics, histological type of primary cancer and metastatic brain tumor, additional synchronous or previous distant metastasis, treatment modalities, locations and characteristics on radiologic findings, time interval between the first diagnosis of the primary thyroid cancer and brain metastasis, thyroglobulin level at the first detection of intracranial metastasis and survival were reviewed.
Results
A total of 10 (0.032 %) out of 3,090 thyroid cancer patients in the National Cancer Center database were identified as having intracranial metastases. The histological types of the primary thyroid cancers were papillary for six patients, follicular for three, and poorly differentiated carcinoma for one. Six of these ten patients underwent surgical resection for intracranial lesions. Whole-brain radiotherapy or tyrosine kinase inhibitors were applied to the patients as postoperative adjuvant treatment, and stereotactic radiosurgery was considered for recurrent or surgically inoperable lesions. The overall median survival time was 33 months (range, 0.5-78 months) after diagnosis of intracranial metastasis.
Conclusions
Surgical resection and adjuvant treatments in the contemporary era seem to result in improved survival after intracranial metastases compared with what has been reported in past studies. Considering the grave course of intracranial metastasis, the early detection and aggressive treatment of patients with a good performance status are crucial.
Similar content being viewed by others
References
Sul J, Posner JB (2007) Brain metastases: epidemiology and pathophysiology. Cancer Treat Res 136:1–21
Chiu AC, Delpassand ES, Sherman SI (1997) Prognosis and treatment of brain metastases in thyroid carcinoma. J Clin Endocrinol Metab 82(11):3637–42
Dinneen SF, Valimaki MJ, Bergstralh EJ, Goellner JR, Gorman CA, Hay ID (1995) Distant metastases in papillary thyroid carcinoma: 100 cases observed at one institution during 5 decades. J Clin Endocrinol Metab 80(7):2041–5
Muresan MM, Olivier P, Leclère J, Sirveaux F, Brunaud L, Klein M, Zarnegar R, Weryha G (2008) Bone metastases from differentiated thyroid carcinoma. Endocr Relat Cancer 15(1):37–49
Schlumberger MJ (1998) Papillary and follicular thyroid carcinoma. N Engl J Med 338(5):297–306
Hoie J, Stenwig AE, Kullmann G, Lindegaard M (1988) Distant metastases in papillary thyroid cancer. A review of 91 patients. Cancer 61(1):1–6
Kim KM, Park JB, Bae KS, Kang SJ (2012) Analysis of prognostic factors in patients with multiple recurrences of papillary thyroid carcinoma. Surg Oncol 21(3):185–90
Lundgren CI, Hall P, Dickman PW, Zedenius J (2006) Clinically significant prognostic factors for differentiated thyroid carcinoma: a population-based, nested case-control study. Cancer 106(3):524–31
Henriques de Figueiredo B, Godbert Y, Soubeyran I, Carrat X, Lagarde P, Cazeau AL, Italiano A, Sargos P, Kantor G, Loiseau H, Bonichon F (2014) Brain metastases from thyroid carcinoma: a retrospective study of 21 patients. Thyroid 24(2):270–6
el Tazi M, Essadi I, Errihani H (2011) Thyroid carcinoma presenting as a dural metastasis mimicking a meningioma: a case report. N Am J Med Sci 3(1):39–42
Nagamine Y, Suzuki J, Katakura R, Yoshimoto T, Matoba N, Takaya K (1985) Skull metastasis of thyroid carcinoma. Study of 12 cases. J Neurosurg 63(4):526–31
Kilfoy BA, Zheng T, Holford TR, Han X, Ward MH, Sjodin A, Zhang Y, Bai Y, Zhu C, Guo GL, Rothman N, Zhang Y (2009) International patterns and trends in thyroid cancer incidence, 1973-2002. Cancer Causes Control 20(5):525–31
Hjiyiannakis P, Jefferies S, Harmer CL (1996) Brain metastases in patients with differentiated thyroid carcinoma. Clin Oncol R Coll Radiol 8(5):327–30
McWilliams RR, Giannini C, Hay ID, Atkinson JL, Stafford SL, Buckner JC (2003) Management of brain metastases from thyroid carcinoma: a study of 16 pathologically confirmed cases over 25 years. Cancer 98(2):356–62
Liebner DA, Shah MH (2011) Thyroid cancer: pathogenesis and targeted therapy. Ther Adv Endocrinol Metab 2(5):173–95
Kloos RT, Ringel MD, Knopp MV, Hall NC, King M, Stevens R, Liang J, Wakely PE Jr, Vasko VV, Saji M, Rittenberry J, Wei L, Arbogast D, Collamore M, Wright JJ, Grever M, Shah MH (2009) Phase II trial of sorafenib in metastatic thyroid cancer. J Clin Oncol 27(10):1675–84
Wells SA Jr, Robinson BG, Gagel RF, Dralle H, Fagin JA, Santoro M, Baudin E, Elisei R, Jarzab B, Vasselli JR, Read J, Langmuir P, Ryan AJ, Schlumberger MJ (2012) Vandetanib in patients with locally advanced or metastatic medullary thyroid cancer: a randomized, double-blind phase III trial. J Clin Oncol 30(2):134–41
Tsao MN, Rades D, Wirth A, Lo SS, Danielson BL, Vichare A, Hahn C, Chang EL (2012) International practice survey on the management of brain metastases: third international consensus workshop on palliative radiotherapy and symptom control. Clin Oncol R Coll Radiol 24(6):e81–92
Kim IY, Kondziolka D, Niranjan A, Flickinger JC, Lunsford LD (2009) Gamma knife radiosurgery for metastatic brain tumors from thyroid cancer. J Neurooncol 93(3):355–9
Bernad DM, Sperduto PW, Souhami L, Jensen AW, Roberge D (2010) Stereotactic radiosurgery in the management of brain metastases from primary thyroid cancers. J Neurooncol 98(2):249–52
Salvati M, Frati A, Rocchi G, Masciangelo R, Antonaci A, Gagliardi FM, Delfini R (2001) Single brain metastasis from thyroid cancer: report of twelve cases and review of the literature. J Neurooncol 51(1):33–40
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflicts of interest
All authors certify that we have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.
Rights and permissions
About this article
Cite this article
Lee, H.S., Yoo, H., Lee, S.H. et al. Clinical characteristics and follow-up of intracranial metastases from thyroid cancer. Acta Neurochir 157, 2185–2194 (2015). https://doi.org/10.1007/s00701-015-2611-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00701-015-2611-5