EP11.01 PALLIATIVE MANAGEMENT OF BRAIN METASTASIS IN FOLLICULAR VARIANT PAPILLARY THYROID CARCINOMA: A CASE REPORT

Abstract BACKGROUND Brain metastases from differentiated thyroid carcinomas are rare, with the follicular variant of papillary thyroid carcinoma (FVPTC) accounting for a minority of cases. Optimal management strategies remain individualized due to limited clinical experience. CASE PRESENTATION We report a case of 75 year-old female diagnosed with FVPTC who presented with right frontal region swelling. FDG PET CT was done which was suggestive of right frontal and temporal bone lesions infiltrating into the adjacent brain parenchyma and few nodules in both the lobes of thyroid gland. Biopsy from the right frontal lesion was positive for metastases from carcinoma of thyroid. The patient initially underwent total thyroidectomy followed by histopathological confirmation of FVPTC. The case was discussed in the internal tumor board of hospital, where decision was taken to treat the brain metastasis with palliative external beam radiotherapy (30Gray/10fractions) followed high-dose radioiodine (150 mci) therapy for systemic disease control. Pre-therapy scans demonstrated iodine avid metastatic brain lesions DISCUSSION This case highlights the rare occurrence of brain metastasis in FVPTC and emphasizes the importance of a multidisciplinary approach, including surgical, radiation, and nuclear medicine interventions. Palliative radiotherapy played a crucial role in symptom control and improving the patient’s performance status, allowing for subsequent high-dose radioiodine therapy, which is essential in achieving systemic disease management in iodine-avid metastases. CONCLUSION Early identification and multimodality management of brain metastases in FVPTC can provide meaningful palliation and may enhance the effectiveness of subsequent systemic radioiodine therapy. This case underscores the critical role of individualized, coordinated care in the management of advanced differentiated thyroid cancers. <!--EndFragment-->