Brain metastasis from differentiated thyroid carcinoma responding to radioiodine therapy

Document Type : Case report

Authors

1 Department of Nuclear Medicine, Hokkaido University Hospital, Sapporo, Japan

2 Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan

3 Department of Diagnostic Imaging, Faculty of Medicine, Hokkaido University, Sapporo, Japan

4 Global Center for Biomedical Science and Engineering, Faculty of Medicine, Hokkaido University, Sapporo, Japan

5 Department of Radiology, Diagnostic Imaging Center, Second State Central Hospital, Ulaanbaatar, Mongolia

6 Division of Medical AI Education and Research, Faculty of Medicine, Hokkaido University, Sapporo, Japan

10.22038/aojnmb.2025.86276.1618

Abstract

Brain metastasis (BM) occurs only in about 1% of differentiated thyroid carcinoma (DTC) cases. Although DTC generally has a good prognosis, once BM develops, the mortality rate significantly increases up to 78%. BM is usually treated by surgical resection or external radiotherapy, whereas radioactive iodine therapy (RAIT) using I-131 is much less often chosen because BM often shows poor uptake of I-131. In addition, even in case I-131 accumulates in the BM, RAIT could cause adverse effects such as brain hemorrhage and cerebral edema.
We present a case of BM from DTC that showed response to I-131 therapy with no severe adverse effects. The brain lesion was very small and asymptomatic, and was only found after a post-therapy I-131 scintigraphy. There are a few case reports where BM was cured by RAIT with little to no side effects. We theorize that BM that is small in size, asymptomatic and show I-131 accumulation could be successfully treated with RAIT.

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References

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Asia Oceania Journal of Nuclear Medicine and Biology
Volume 13, Issue 2
July 2025
Pages 208-212

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