|
|
Management
of brain metastases from thyroid carcinoma: a study of 16 pathologically
confirmed cases over 25 years
McWilliams RR, Giannini C, Hay ID, Atkinson JL, Stafford SL, Buckner JC
Division of Medical Oncology, Mayo Clinic and Foundation,
Rochester, Minnesota 55905, USA.
mcwilliams.robert@mayo.edu
Background. Brain metastasis is an uncommon, morbid complication of
metastatic thyroid carcinoma.
Because of its rarity, management often is problematic.
To help contribute to the management of this disease entity, the authors present
herein what to their knowledge is the largest series reported to date in which
all patients had biopsy proven confirmation of their brain metastases.
Methods. The authors report a series of 16 patients with metastatic thyroid
carcinoma to the brain who were treated between 1976-2000.
The Mayo Clinic database was used to locate and review charts and radiology and
pathology reports, and all biopsy specimens were reviewed by one
pathologist.
The histologic types of carcinoma included 10 papillary carcinomas, 2 follicular
carcinomas, 1 Hurthle cell carcinoma, 1 medullary carcinoma, 1 insular
carcinoma, and 1 anaplastic carcinoma.
Given the small sample size, statistical analyses were not performed.
Results. Surgical resection of brain metastases was associated with a trend
toward longer survival (20.8 months vs. 2.7 months for no surgical intervention
in selected patients).
Whole brain external beam radiation therapy produced disease regression in three
of the four evaluable patients.
Gamma knife radiosurgery and radioactive iodine therapy appear to play limited,
but beneficial, therapeutic roles.
Overall, survival after the diagnosis of brain metastasis is reported to be
longer than that noted with other solid tumors (17.4 months), and the majority
of patients die of their extracranial disease (85% in the current series).
Conclusions. The results of the current study indicate that local therapies appear to
control brain metastases in the large majority of thyroid carcinoma patients
with metastases to the brain.
Copyright 2003 American Cancer Society.
PMID: 12872357 [PubMed - in process]
Source:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12872357&dopt=Abstract
|
