MANAGEMENT OF INTRACRANIAL METASTASES OF DIFFERENTIATED CARCINOMA OF THYROID

Brain metastases in differentiated carinoma of the thyroid is a rare o ccurrence. We treated five documented cases of carcinoma of thyroid wi th brain metastases out of 400 cases of thyroid cancer treated between 1972 to 1993. 4 were females out of which one was pregnant during the appearance of brain metastases. All cases were treated with thyroidec tomy, and radioiodine as primary therapy. Brain metastases developed 6 months to 11 years following treatment of the primary and were treate d with radiotherapy and suppressive levothyroxine. We observed the ben eficial effect of suppressive thyroxine and the poor prognosis associa ted with pregnancy and withdrawl of thyroid replacement therapy. 3 of the 5 patients are alive 12-23 months after treatment for brain metast ases, while 2 patients died at 4 months and 7 years post brain metasta ses due to pulmonary and hepatic failure, respectively.