SOLITARY BRAIN METASTASES FROM THYROID-CARCINOMA - STUDY OF 6 CASES

Aims and background: Although systemic metastases from thyroid cancer are relatively frequent, they rarely affect the nervous system and onl y exceptionally originate from well-differentiated carcinoma. Methods: The authors describe 6 cases of solitary brain metastases from thyroi d carcinoma, well-differentiated in 3 cases and anaplastic in the othe r 3 cases. Results: Four patients were females and 2 males (M:F ratio, 1:2); average age was 51 yrs (range 48-56). On average, the interval between diagnosis of the thyroid tumor and appearance of the metastasi s was 2.8 years (range 1-12 years) and was shorter in the anaplastic f orms (1.2 versus 4.4 years). Average survival was 15 months (range 6-4 8 months); in particular, average survival was longer in patients with well-differentiated carcinoma (9 vs 21 months) as also in those who d id not present other metastatic sites (6 vs 24 months). Death was due to systemic progression of the disease in 4 cases and to brain-relapse in the other 2 cases. Conclusions: Surgery, radioactive iodine (where uptake is demonstrable), and radiotherapy are the main therapies avai lable for metastases from thyroid carcinoma. However, survival of pati ents appears to be modified by the type of treatment performed.