脳内出血にて発症した甲状腺乳頭癌脳転移の1例

Brain Metastasis from Papillary Thyroid Carcinoma with Acute Intracerebral Hemorrhage: A Surgical Case Report

Ⅰ．はじめに

　甲状腺乳頭癌は甲状腺の悪性腫瘍の中では最も頻度の高い疾患である．甲状腺被膜外浸潤，リンパ節転移，遠隔転移を伴うことが知られているが，このうち，脳転移は約0.8～1.3％と稀である^2,4,15,23)．

　今回われわれは，脳内出血で発症した甲状腺乳頭癌脳転移の1例を経験したので，文献的考察を加えて報告する．

　We report a rare case of brain metastasis from papillary thyroid carcinoma with intracerebral hemorrhage. A 79-year-old woman presented with sudden headache and monoplegia of the right upper limb 10 years after diagnosis of thyroid papillary adenocarcinoma. Despite the known metastatic lesions in the cervical lymph nodes and lungs,she had been well for 10 years since thyroidectomy,focal irradiation and internal radiation of ¹³¹I. CT demonstrated intracerebral hemorrhage in the left temporal lobe. Magnetic resonance imaging showed marked signal heterogeneity. She underwent radical surgery on the day of the onset and the histological diagnosis was metastatic brain tumor of thyroid papillary carcinoma. Postoperative course was uneventful,and the monoplegia was improved. Papillary thyroid carcinoma has a relatively benign course,and surgical removal of the brain metastasis is able to contribute to longer survival times for patients.