Radioactive Iodine-Refractory Differentiated Thyroid Cancer with Brain Metastasis: A Clinical Case Report
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Abstract
Background: Differentiated thyroid cancer (DTC) is mainly treated with surgery and radioactive iodine (RAI), and typically has a favorable prognosis. Cases with distant metastasis often have a poorer prognosis and are at risk of becoming resistant to radioactive iodine. Progressive radioactive iodine-refractory DTC with brain metastasis is extremely rare and carries a grave prognosis, requiring a multimodal treatment approach. This report describes a typical clinical case, emphasizing diagnostic and therapeutic strategies.
Case Description: A 65-year-old female patient, diagnosed with papillary thyroid carcinoma, underwent total thyroidectomy and received four RAI treatments (total dose: 600 mCi) for lung and left 7th rib metastases. The patient was confirmed RAI-refractory and subsequently developed local recurrence and progressive brain metastasis during follow-up. Systemic chemotherapy with lenvatinib and brain radiotherapy were administered.
Results: After one year of treatment, the brain lesions reduced in size, thyroglobulin levels progressively decreased, and the patient remained clinically stable.
Conclusion: RAI-refractory DTC with brain metastasis is rare and associated with a poor prognosis. Systemic therapy combined with localized treatment modalities can effectively control disease progression.
Keywords
Radioactive iodine, radioactive iodine-refractory differentiated thyroid cancer, radioactive iodine-refractory differentiated thyroid cancer with brain metastasis
Article Details
References
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