{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T06:24:11Z","timestamp":1777962251439,"version":"3.51.4"},"reference-count":36,"publisher":"Bioscientifica","issue":"4","license":[{"start":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T00:00:00Z","timestamp":1696118400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["edm.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,10,1]]},"abstract":"<jats:sec>\n<jats:title>Summary<\/jats:title>\n<jats:p>We report a 61-year-old male patient without personal history of thyroid carcinoma or radiation exposure. In 2011, he presented with a cervical mass whose biopsy diagnosed a papillary thyroid carcinoma (PTC) in a lymph node metastasis (LNM). Total thyroidectomy with lymphadenectomy of central and ipsilateral compartment was performed. Histopathology identified a 2 mm follicular variant of PTC and LNM in 25\/25 lymph nodes. The patient was treated with 150 mCi of radioactive iodine (RAI), followed by levothyroxine suppressive therapy. In 2016, a retrotracheal mass was diagnosed, suggesting local recurrence; patient was submitted to surgical excision and RAI therapy (120 mCi). Due to seizures, in 2019, a brain CT was performed that diagnosed brain metastases. The patient underwent debulking of the main lesion. Histopathology analysis confirmed a metastatic lesion with variated morphology: classical PTC and follicular pattern and hobnail and tall cell features. Molecular analysis revealed BRAFV600E in LNM at presentation and BRAFV600E and TERT promoter (TERTp) mutations in the recurrent LNM and brain metastasis. Based upon this experience we review the reported cases of subcentimetric PTC with brain metastases and discuss the molecular progression of the present case.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Learning points<\/jats:title>\n<jats:list list-type=\"bullet\">\n<jats:list-item>\n<jats:p>Papillary microcarcinoma (PMCs) usually have very good prognosis with low impact on patient survival.<\/jats:p>\n<\/jats:list-item>\n<jats:list-item>\n<jats:p>PMCs presenting in elderly patients with LNM at diagnosis may carry a guarded outcome.<\/jats:p>\n<\/jats:list-item>\n<jats:list-item>\n<jats:p>Brain metastasis although rare indicate aggressive phenotypic features.<\/jats:p>\n<\/jats:list-item>\n<jats:list-item>\n<jats:p>Patient risk stratification of PMCs based on histopathological analysis and genetic testing may have a significant impact on prognosis providing therapeutic markers, that may predict disease progression and overall outcome.<\/jats:p>\n<\/jats:list-item>\n<\/jats:list>\n<\/jats:sec>","DOI":"10.1530\/edm-23-0025","type":"journal-article","created":{"date-parts":[[2023,12,18]],"date-time":"2023-12-18T11:48:13Z","timestamp":1702900093000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":3,"title":["Subcentimetric papillary thyroid carcinoma with extensive lymph node and brain metastasis: case report and review of literature"],"prefix":"10.1530","volume":"2023","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3305-8201","authenticated-orcid":true,"given":"Andreia","family":"Amado","sequence":"first","affiliation":[{"name":"Centro Hospitalar Vila Nova de Gaia\/Espinho, Portugal, R. Concei\u00e7\u00e3o Fernandes S\/N, 4434-502 Vila Nova de Gaia, Portugal"}]},{"given":"Elisabete","family":"Teixeira","sequence":"additional","affiliation":[{"name":"i3S - Instituto de Investiga\u00e7\u00e3o e Inova\u00e7\u00e3o em Sa\u00fade, Universidade do Porto, R. Alfredo Allen 208, 4200-135 Porto, Portugal"},{"name":"IPATIMUP - Instituto de Patologia e Imunologia Molecular da Universidade do Porto, Rua J\u00falio Amaral de Carvalho 45, 4200-135 Porto, Portugal"},{"name":"Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"given":"Sule","family":"Canberk","sequence":"additional","affiliation":[{"name":"i3S - Instituto de Investiga\u00e7\u00e3o e Inova\u00e7\u00e3o em Sa\u00fade, Universidade do Porto, R. Alfredo Allen 208, 4200-135 Porto, Portugal"},{"name":"IPATIMUP - Instituto de Patologia e Imunologia Molecular da Universidade do Porto, Rua J\u00falio Amaral de Carvalho 45, 4200-135 Porto, Portugal"},{"name":"Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"given":"Sofia","family":"Macedo","sequence":"additional","affiliation":[{"name":"i3S - Instituto de Investiga\u00e7\u00e3o e Inova\u00e7\u00e3o em Sa\u00fade, Universidade do Porto, R. Alfredo Allen 208, 4200-135 Porto, Portugal"},{"name":"IPATIMUP - Instituto de Patologia e Imunologia Molecular da Universidade do Porto, Rua J\u00falio Amaral de Carvalho 45, 4200-135 Porto, Portugal"},{"name":"Instituto de Ci\u00eancias Biom\u00e9dicas de Abel Salazar, Universidade do Porto, R. Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal"}]},{"given":"B\u00e1rbara","family":"Castro","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Vila Nova de Gaia\/Espinho, Portugal, R. Concei\u00e7\u00e3o Fernandes S\/N, 4434-502 Vila Nova de Gaia, Portugal"}]},{"given":"Hugo","family":"Pereira","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Vila Nova de Gaia\/Espinho, Portugal, R. Concei\u00e7\u00e3o Fernandes S\/N, 4434-502 Vila Nova de Gaia, Portugal"}]},{"given":"Jo\u00e3o","family":"Varanda","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Vila Nova de Gaia\/Espinho, Portugal, R. Concei\u00e7\u00e3o Fernandes S\/N, 4434-502 Vila Nova de Gaia, Portugal"}]},{"given":"Susana","family":"Gra\u00e7a","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Vila Nova de Gaia\/Espinho, Portugal, R. Concei\u00e7\u00e3o Fernandes S\/N, 4434-502 Vila Nova de Gaia, Portugal"}]},{"given":"Am\u00e9lia","family":"Tavares","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Vila Nova de Gaia\/Espinho, Portugal, R. Concei\u00e7\u00e3o Fernandes S\/N, 4434-502 Vila Nova de Gaia, Portugal"},{"name":"i3S - Instituto de Investiga\u00e7\u00e3o e Inova\u00e7\u00e3o em Sa\u00fade, Universidade do Porto, R. Alfredo Allen 208, 4200-135 Porto, Portugal"},{"name":"IPATIMUP - Instituto de Patologia e Imunologia Molecular da Universidade do Porto, Rua J\u00falio Amaral de Carvalho 45, 4200-135 Porto, Portugal"},{"name":"Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"given":"Carlos","family":"Soares","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Vila Nova de Gaia\/Espinho, Portugal, R. Concei\u00e7\u00e3o Fernandes S\/N, 4434-502 Vila Nova de Gaia, Portugal"}]},{"given":"Maria Jo\u00e3o","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Vila Nova de Gaia\/Espinho, Portugal, R. Concei\u00e7\u00e3o Fernandes S\/N, 4434-502 Vila Nova de Gaia, Portugal"}]},{"given":"Manuel","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Vila Nova de Gaia\/Espinho, Portugal, R. Concei\u00e7\u00e3o Fernandes S\/N, 4434-502 Vila Nova de Gaia, Portugal"}]},{"given":"Paula","family":"Soares","sequence":"additional","affiliation":[{"name":"i3S - Instituto de Investiga\u00e7\u00e3o e Inova\u00e7\u00e3o em Sa\u00fade, Universidade do Porto, R. Alfredo Allen 208, 4200-135 Porto, Portugal"},{"name":"IPATIMUP - Instituto de Patologia e Imunologia Molecular da Universidade do Porto, Rua J\u00falio Amaral de Carvalho 45, 4200-135 Porto, Portugal"},{"name":"Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"given":"Manuel","family":"Sobrinho Sim\u00f5es","sequence":"additional","affiliation":[{"name":"i3S - Instituto de Investiga\u00e7\u00e3o e Inova\u00e7\u00e3o em Sa\u00fade, Universidade do Porto, R. Alfredo Allen 208, 4200-135 Porto, Portugal"},{"name":"IPATIMUP - Instituto de Patologia e Imunologia Molecular da Universidade do Porto, Rua J\u00falio Amaral de Carvalho 45, 4200-135 Porto, Portugal"},{"name":"Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"},{"name":"Centro Hospitalar Universit\u00e1rio S\u00e3o Jo\u00e3o, Porto, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"given":"Ant\u00f3nia Afonso","family":"P\u00f3voa","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Vila Nova de Gaia\/Espinho, Portugal, R. Concei\u00e7\u00e3o Fernandes S\/N, 4434-502 Vila Nova de Gaia, Portugal"},{"name":"i3S - Instituto de Investiga\u00e7\u00e3o e Inova\u00e7\u00e3o em Sa\u00fade, Universidade do Porto, R. Alfredo Allen 208, 4200-135 Porto, Portugal"},{"name":"IPATIMUP - Instituto de Patologia e Imunologia Molecular da Universidade do Porto, Rua J\u00falio Amaral de Carvalho 45, 4200-135 Porto, Portugal"},{"name":"Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]}],"member":"416","reference":[{"key":"bib1","series-title":"Endocrine Journal","first-page":"653","article-title":"Cerebellar metastasis as first metastasis from papillary thyroid carcinoma","volume":"52","author":"Pazaitou-Panayiotou","year":"2005","unstructured":"Pazaitou-Panayiotou KKaprara AChrisoulidou ABoudina MGeorgiou EPatakiouta FDrimonitis A & Vainas I. Cerebellar metastasis as first metastasis from papillary thyroid carcinoma. Endocrine Journal200552653\u2013657. 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