title: Cerebellum as Initial Site of Distant Metastasis from Papillary Carcinoma of Thyroid: Review of Three Cases.
abstract: Background. The cerebellum as initial site of distant metastasis from differentiated thyroid carcinoma (DTC) including papillary (PTC) and follicular thyroid carcinoma (FTC) is rare manifestation. Case Presentations. Herein, we present three cases of cerebellar metastasis (CBM) of PTC. Mean age of patients was 67 years (range: 64-72), and mean duration between initial diagnosis and CBM was 49.6 months (range: 37-61). Frequent location was left cerebellar hemisphere and was associated with hydrocephalus. All patients underwent suboccipital craniectomy, and in two patients postoperative intensity modulated radiation therapy (IMRT) was given to deliver 5000 cGy in 25 fractions to residual lesions. Patient without postoperative IMRT had cerebellar recurrence along with lung and bone metastasis after 38 months. However, two patients were found alive and free of disease at the time of last follow-up. Conclusion. CBM from PTC is a rare clinical entity and is often associated with hydrocephalus. Histopathological diagnosis is important to initiate effective treatment, which relies on multidisciplinary approach to prolong the disease-free and overall survival rates.
authors.affiliation: Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh 59046, Saudi Arabia.
authors.forename: Mutahir A
authors.initials: MA
authors.lastname: Tunio
authors.affiliation: Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh 59046, Saudi Arabia.
authors.forename: Mushabbab
authors.initials: M
authors.lastname: Al Asiri
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Khalid Hussain
authors.initials: KH
authors.lastname: Al-Qahtani
authors.affiliation: Histopathology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh 59046, Saudi Arabia.
authors.forename: Wafa
authors.initials: W
authors.lastname: AlShakweer