Solitary brain metastasis from papillary thyroid carcinoma in a patient with depression: Report of a case

Papillary carcinoma of the thyroid is a common thyroid malignancy with a re latively good prognosis. However, distant metastases may develop and become threatening, particularly to older patients, in a more aggressive manner. We report herein the clinical, radiological, and pathological findings of a patient with papillary thyroid carcinoma who had a solitary cerebral metas tasis, The patient had been suffering from depression and had already under gone a hemithyroidectomy for primary thyroid carcinoma, and was known to ha ve metastatic thryoid carcinoma of the lungs and bone. After the removal of the remnant thyroid gland prior to radioiodine (I-131) therapy, he develop ed additional problems related to depression. Electroencephalography played an important role in identifying suspected brain metastasis and computed t omography demonstrated a space-occupying lesion in the left cerebral hemisp here. Consequently, an early removal of intracranial mass could be performe d without any further life-threatening complications. Moreover, after remov al of the brain mass the patient's depression improved immediately without the use of any antidepressants. This case report indicates the possibility that a patient's depression might be associated with brain metastasis from papillary thyroid carcinoma, and also suggests that an early diagnosis with the appropriate surgical management of a brain metastasis followed by radi oiodine therapy could be valuable for achieving a prolonged disease-free pe riod.