Abstract
A 63-year-old female presented with urinary incontinence. A cystic lesion was found in the right frontal lobe by magnetic resonance imaging (MRI), and was diagnosed as old cerebral hemorrhage. Thereafter, she had memory disturbance, disorientation, hemiparesis, and gait disturbance. Computed tomography (CT) of the head showed the enlargement of the lesion and perilesional edema. The lesion was resected under the diagnosis of cavernous hemangioma by imaging means. Since the histological examination revealed metastatic adencarcinoma, CyberKnife radiosurgery was added around the resected area. Detailed search of primary lesion showed a 19 × 14 × 13 mm low density area in the right lobe of the thyroid, and it was diagnosed with papillary thyroid carcinoma by fine needle aspiration cytology. After total thyroidectomy, postoperative 131I therapy was added. One month after the surgery, recurrence of brain metastasis was pointed out by urinary incontinence. She received CyberKnife radiosurgery in the recurrent lesion. She has had no recurrence, as of 3 years after the onset of the disease.
Multimodal treatments were effective for the cerebral metastasis from papillary thyroid carcinoma which was difficult to discriminate from cavernous hemangioma.
