Brain Metastases from Papillary Adenocarcinoma of the Thyroid
Bibliographic record
Abstract
BACKGROUND: Papillary thyroid adenocarcinoma (PTA) is the most common type of thyroid malignancy. Distant metastatic spread is relatively rare, most commonly affecting the lungs and bone. Brain metastases are very uncommon. We present a series of four patients with this development and review their diagnosis and treatment. METHODS: A retrospective chart review analysis of patients diagnosed with PTA between 1983 and 2003 at St. Joseph's Healthcare Centre in Hamilton, Ontario, was conducted. RESULTS: Four patients with brain metastasis from their PTA were identified. Three were female and one was male. Their ages at the initial presentation ranged from 20 to 67 years (mean 48 years). The time between the initial treatment and presentation of distant metastasis ranged from 15 to 167 months (mean 89 months). Thyroglobulin data were followed on all four patients. Thyroglobulin results rose with the development of brain and other distant metastasis for two patients but never increased in the other two patients despite distant metastases at multiple sites. Treatment of brain metastasis was with a combination of surgery, external beam radiation, and radioactive iodine. All patients eventually died of their disease, and the overall survival after the diagnosis of brain metastases was 15.3 months in the four patients. CONCLUSION: This study shows that brain metastasis may or may not be the first site of distant metastasis in patients with PTA. The distant metastasis cannot always be predicted from thyroglobulin data. Once brain metastases are diagnosed, palliation with preservation of quality of life becomes the goal of therapy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".