title: Long-term survival in a patient with brain metastases of papillary thyroid carcinoma.
abstract: We present the case of a 43-year-old woman who underwent total thyroidectomy with bilateral lymphadenectomy for a papillary thyroid carcinoma (PTC), solid variant (T4bN1bMx), with V600E BRAF mutation. After ablative therapy, she presented undetectable thyroglobulin (Tg) but progressively increasing anti-Tg antibodies (TgAbs). During follow-up, nodal, lung and brain metastases were identified. She was submitted to surgical excision of lung lesions, radiosurgery of brain metastases and five radioiodine treatments. The latest brain MRI showed no lesions, pulmonary CT showed stable micronodules and there was progressive reduction in TgAbs. This is a peculiar case of a PTC with lung and brain metastatic lesions detected through TgAbs. Initial histological and molecular study suggested a more aggressive clinical behaviour, which was eventually confirmed. Although PTC brain metastases are extremely rare and present poor prognosis, our patient presented a good response to treatment and longer survival than usually reported for similar cases.
authors.affiliation: Endocrinology, Diabetes and Metabolism Department, Coimbra Hospital and University Centre, Coimbra, Portugal Faculty of Medicine of University of Coimbra, Coimbra, Portugal.
authors.forename: Daniela
authors.initials: D
authors.lastname: Guelho
authors.affiliation: Endocrinology, Diabetes and Metabolism Department, Coimbra Hospital and University Centre, Coimbra, Portugal.
authors.forename: Cristina
authors.initials: C
authors.lastname: Ribeiro
authors.affiliation: Endocrinology, Diabetes and Metabolism Department, Coimbra Hospital and University Centre, Coimbra, Portugal Faculty of Medicine of University of Coimbra, Coimbra, Portugal.
authors.forename: Miguel
authors.initials: M
authors.lastname: Melo
authors.affiliation: Endocrinology, Diabetes and Metabolism Department, Coimbra Hospital and University Centre, Coimbra, Portugal.
authors.forename: Francisco
authors.initials: F
authors.lastname: Carrilho
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology; D001932:Brain Neoplasms / Q000532:radiotherapy / Q000556:secondary*; D002277:Carcinoma / Q000473:pathology* / Q000556:secondary / Q000628:therapy; D002291:Carcinoma, Papillary; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008175:Lung Neoplasms / Q000556:secondary / Q000601:surgery; D009154:Mutation; D013534:Survival; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000556:secondary / Q000628:therapy; D013965:Thyroidectomy
chemical_list: D007457:Iodine Radioisotopes