Case report

Cerebellar mass as a primary presentation of papillary thyroid carcinoma: case report and literature review

Saleh F Al-Dhahri^1*, Abdullah S Al-Amro², Wafa Al-Shakwer³ and Abdullah S Terkawi¹

• * Corresponding author: Saleh F Al-Dhahri saldhahri@kfmc.med.sa

Author Affiliations

¹ Head & Neck department, King Fahad Medical City, Riyadh, Saudi Arabia

² Radiation Oncology department, King Fahad Medical City, Riyadh, Saudi Arabia

³ Pathology department, King Fahad Medical City, Riyadh, Saudi Arabia

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Head & Neck Oncology 2009, 1:23 doi:10.1186/1758-3284-1-23

Published: 29 June 2009

Abstract

Background

Papillary carcinoma is the most common differentiated malignant thyroid neoplasm. The biological course of this cancer is typically indolent with a protracted clinical course. Metastases commonly occur in regional lymph nodes, and distant metastasis is a late and rare occurrence. We report a patient who presented with cerebellar metastasis prior to the diagnosis of papillary thyroid carcinoma and review the literature of brain metastasis from papillary thyroid carcinoma.

Results

A 75-year old female presented at the emergency room with progressive dizziness, headache and vomiting, where a brain CT and MRI showed a posterior cerebellar tumor. Surgical resection revealed papillary carcinoma consistent with thyroid origin. Subsequent ultrasound and CT-scan revealed a thyroid nodule, after which the patient underwent total thyroidectomy. Pathologic evaluation was consistent with papillary thyroid carcinoma.

Conclusion

Brain metastasis may rarely be the initial presentation of papillary thyroid carcinoma. Solitary brain metastasis can completely be resected with better prognosis.