Iodine-131 Whole Body Scintigraphy Demonstrating Papillary Thyroid Carcinoma with Initial Manifestation of Neurological Deficits

甲狀腺乳突癌約占所有甲狀腺癌的80%，其中約十分之一會有遠端轉移，而遠端轉移當中的0.4%-1.2%位於顱內。我們提出一個罕見病例，患者初始的臨床表現爲神經變化，包括半邊臉部肌肉運動困難、聽力喪失、耳鳴與眩暈，影像學檢查發現顱內右側岩骨上的腫瘤。患者拒絕開顱手術，而接受局部放射治療，並在治療後症狀大幅減輕。另外，其左側的甲狀腺腫塊經細針抽吸切片證實爲良性囊腫，且病人甲狀腺功能正常，然唯恐頸部左側腫塊日益增大壓迫氣管，故進行甲狀腺切除術。病理組織報告發現右側甲狀腺爲乳突癌，再經碘－131全身閃爍照影顯示顱內右側岩骨上的病灶其實是甲狀腺癌顱內轉移。我們探討碘－131全身閃爍照影在此病例當中所扮演之重要的輔助診斷的角色，針對臨床表現與影像學上的發現加以討論，藉此早期診斷及鑑別診斷。

關鍵字

顱內轉移；碘－131全身閃爍照影術；甲狀腺乳突癌；放射治療

並列摘要

In this report we presented a rare case of papillary thyroid carcinoma with neurological deficits as sole manifestation. With the patient's refusal of craniotomy, stereotactic radiotherapy (SRT) was administered to the tumor in the right petrous bone and the patient later pronounced improvement in most neurological abnormalities. The long-standing mass in left side of her neck proved to be goiter cytologically. Once surgical exploration of the thyroid gland was employed, discovery of cancerous tissue in the right lobe led to further imaging with radioactive iodine. A 131I whole body scintigraphy divulged metastatic thyroid tissue in the base of skull and differentiated intracranial metastatic thyroid carcinoma from neurogenic tumors.

並列關鍵字

intracranial metastasis ； 131I whole body scintigraphy ； papillary thyroid carcinoma ； radiotherapy

國際替代計量

Iodine-131 Whole Body Scintigraphy Demonstrating Papillary Thyroid Carcinoma with Initial Manifestation of Neurological Deficits

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