Thyroid Carcinoma Metastasis to Skull with Infringement of Brain: Treatment with Radioiodine
| Autor: | Yuni K. Dewaraja, Eric Wizauer, James C. Sisson, Anca M. Avram, Thomas J. Giordano |
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| Rok vydání: | 2009 |
| Předmět: |
Male
endocrine system Pathology medicine.medical_specialty endocrine system diseases Endocrinology Diabetes and Metabolism medicine.medical_treatment Skull Neoplasms Thyroid Function Tests Radiation Dosage Thyroglobulin Thyroid function tests Metastasis Iodine Radioisotopes Thyroid carcinoma Case Studies Endocrinology medicine Carcinoma Humans Thyroid Neoplasms Aged Tomography Emission-Computed Single-Photon medicine.diagnostic_test Brain Neoplasms business.industry Skull Thyroid Brain Skull Neoplasm medicine.disease Magnetic Resonance Imaging Carcinoma Papillary medicine.anatomical_structure Radiology Radiopharmaceuticals Tomography X-Ray Computed business |
| Zdroj: | Thyroid. 19:297-303 |
| ISSN: | 1557-9077 1050-7256 |
| DOI: | 10.1089/thy.2008.0426 |
| Popis: | Infringement by differentiated thyroid carcinoma on the brain is rare but, when suspected, the patient deserves special attention. A patient with an enlarging metastasis of thyroid carcinoma to the skull that was impinging on the brain illustrates diagnostic and therapeutic strategies applicable to the treatment of metastatic carcinoma.A case study was performed. Computed tomography (CT) and magnetic resonance imaging (MRI) were done, serum thyroglobulin was measured, and tumor responses to thyroxine and (131)I treatments were monitored. Tumor dosimetry, enabled by scintigraphy with (131)I employing single photon emission tomography fused with CT (SPECT-CT), was performed.The metastasis was from a follicular variant of papillary thyroid carcinoma. During thyrotropin stimulation the tumor enlarged. The tumor decreased in volume after each of two (131)I therapies. Dosimetry indicated delivery of 1970 and 2870 cGy to the tumor and 35 and 42 cGy to the brain, respectively, in the two treatments. The patient has survived for more than 11 years since diagnosis.A metastasis from a follicular variant of papillary carcinoma increased in volume during hypothyroidism producing more infringement on the brain. Beyond the effects of thyroxine therapy, (131)I treatments induced recession of tumor volume. In patients with metastases that concentrate (131)I, dosimetry with SPECT-CT can predict absorbed doses of radiation to the tumor and to the adjacent organs and thus lay a basis for data-based decisions on (131)I therapies. Therapy may induce prolonged survival in patients with metastases infringing on the brain. |
| Databáze: | OpenAIRE |
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