Intracranial metastases from thyroid cancer are rare. Although the prognosis of thyroid cancer patients is generally favorable, the prognosis of patients with intracranial metastases from thyroid cancer has been considered unfavorable owing to lower survival rates among such patients compared to those without intracranial involvement. Many questions about their management remain unclear. The aim of the present study was to analyze the characteristics, treatment modalities, and outcomes of patients with brain metastases from thyroid cancer. Among 4320 patients with thyroid cancer recorded in our institutional database over a 30-year period, the data of 20 patients with brain metastasis were retrospectively collected and analyzed. The clinical characteristics, histological type of primary cancer and metastatic brain tumor, additional previous distant metastasis, treatment modalities, locations and characteristics on radiologic findings, time interval between the first diagnosis of primary thyroid cancer and brain metastasis, and survival were analyzed. Among our patient cohort, the mean age at initial diagnosis was 59.3 ± 14.1 years, and at the manifestation of diagnosis of cerebral metastasis, the mean age was found to be 64.8 ± 14.9 years. The histological types of primary thyroid cancer were identified as papillary in ten patients, follicular in seven, and poorly differentiated carcinoma in three. The average interval between the diagnosis of thyroid cancer and brain metastasis was 63.4 ± 58.4 months (range: 0–180 months). Ten patients were identified as having a single intracranial lesion, and ten patients were found to have multiple lesions. Surgical resection was primarily performed in fifteen patients, and whole-brain radiotherapy, radiotherapy, or tyrosine kinase inhibitors were applied in the remaining five patients. The overall median survival time was 15 months after the diagnosis of BMs from TC (range: 1–252 months). Patients with thyroid cancer can develop brain metastasis even many years after the diagnosis of the primary tumor. The results of our study demonstrate increased overall survival in patients younger than 60 years of age at the time of diagnosis of brain metastasis. There was no difference in survival between patients with brain metastasis from papillary carcinoma and those with follicular thyroid carcinoma.
甲状腺癌颅内转移较为罕见。尽管甲状腺癌患者总体预后良好，但伴颅内转移者的预后通常被认为不佳，因其生存率低于无颅内转移的患者。目前针对此类转移的管理策略仍存在诸多未明之处。本研究旨在分析甲状腺癌脑转移患者的临床特征、治疗模式及预后结局。通过回顾性分析我院30年间数据库收录的4320例甲状腺癌患者资料，共筛选出20例脑转移病例。研究内容包括临床特征、原发癌与转移瘤组织学类型、既往远处转移史、治疗方案、影像学特征与病灶定位、原发癌确诊至脑转移发生的时间间隔以及生存情况。研究队列中，患者初诊平均年龄为（59.3±14.1）岁，脑转移确诊时平均年龄为（64.8±14.9）岁。原发甲状腺癌组织学类型包括乳头状癌10例、滤泡状癌7例、低分化癌3例。从甲状腺癌确诊到脑转移发生的平均间隔时间为（63.4±58.4）个月（范围：0-180个月）。颅内单发病灶与多发病灶各10例。15例患者主要接受手术切除治疗，其余5例采用全脑放疗、定向放疗或酪氨酸激酶抑制剂治疗。甲状腺癌脑转移确诊后的中位总生存期为15个月（范围：1-252个月）。研究显示甲状腺癌患者在原发肿瘤确诊多年后仍可能发生脑转移。脑转移确诊年龄低于60岁的患者总生存期显著延长。乳头状癌与滤泡状癌所致脑转移患者的生存期无统计学差异。
Brain Metastases from Thyroid Carcinoma: Prognostic Factors and Outcomes
肿瘤(癌症)患者之家