{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T22:35:34Z","timestamp":1769726134142,"version":"3.49.0"},"reference-count":40,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"18","license":[{"start":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T00:00:00Z","timestamp":1762128000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2025,11,3]]},"abstract":"\n BACKGROUND<\/jats:title>\n Brain metastases are an exceptionally rare and diagnostically challenging manifestation of differentiated thyroid carcinoma (DTC) in pediatric and young adult patients. The authors present the case of a 21-year-old woman with a history of follicular variant papillary thyroid carcinoma who developed multiple intracranial lesions concerning for metastases.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n The patient had previously undergone total thyroidectomy and radioactive iodine ablation, with normal serum thyroglobulin and no known systemic spread. Brain biopsy was deferred given the location of the lesions and the risk associated with biopsy.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n Despite the rarity of brain metastases in pediatric and young adult populations with DTC, especially in the absence of concurrent extracranial disease, this case highlights the importance of thorough neurological evaluation and consideration of CSF thyroglobulin as a potential marker. This case emphasizes the need for vigilance in surveillance and an alternative to brain biopsy when intracranial metastasis is suspected.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE25386<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case25386","type":"journal-article","created":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:06:53Z","timestamp":1762214813000},"source":"Crossref","is-referenced-by-count":0,"title":["A rare case of isolated metastatic disease in a young woman with papillary thyroid carcinoma and a novel method for diagnosis: illustrative case"],"prefix":"10.3171","volume":"10","author":[{"given":"Madison B.","family":"Caldwell","sequence":"first","affiliation":[{"name":"Medical School, University of Michigan, Ann Arbor"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jathan","family":"Young","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Michigan, Ann Arbor"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Simon","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Michigan, Ann Arbor"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suresh N.","family":"Magge","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurosurgery, University of Michigan, Ann Arbor, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"1","key":"bib1","series-title":"J Surg Res","first-page":"167","article-title":"Pediatric thyroid carcinoma: incidence and outcomes in 1753 patients","volume":"156","author":"Hogan","year":"2009","unstructured":"Hogan ARZhuge YPerez EAKoniaris LGLew JISola JE.Pediatric thyroid carcinoma: incidence and outcomes in 1753 patients. J Surg Res. 2009;156(1):167-172."},{"issue":"11","key":"bib2","series-title":"Thyroid","first-page":"1353","article-title":"Clinicopathologic characteristics of pediatric follicular variant of papillary thyroid carcinoma subtypes: a retrospective cohort study","volume":"32","author":"Halada","year":"2022","unstructured":"Halada SBaran JABauer AJClinicopathologic characteristics of pediatric follicular variant of papillary thyroid carcinoma subtypes: a retrospective cohort study. Thyroid. 2022;32(11):1353-1361."},{"issue":"1","key":"bib3","series-title":"Curr Opin Oncol","first-page":"59","article-title":"Differentiated thyroid cancer in children: diagnosis and management","volume":"20","author":"Dinauer","year":"2008","unstructured":"Dinauer CABreuer CRivkees SA.Differentiated thyroid cancer in children: diagnosis and management. Curr Opin Oncol. 2008;20(1):59-65."},{"issue":"11","key":"bib4","series-title":"Pediatr Blood Cancer","first-page":"1942","article-title":"Follicular variant papillary thyroid carcinoma in a pediatric population","volume":"62","author":"Lerner","year":"2015","unstructured":"Lerner JGoldfarb M.Follicular variant papillary thyroid carcinoma in a pediatric population. Pediatr Blood Cancer. 2015;62(11):1942-1946."},{"issue":"13","key":"bib5","series-title":"Cancers (Basel)","first-page":"2371","article-title":"Brain metastases from thyroid carcinoma: prognostic factors and outcomes","volume":"16","author":"Esmaeilzadeh","year":"2024","unstructured":"Esmaeilzadeh MAtallah OM\u00fcller JABrain metastases from thyroid carcinoma: prognostic factors and outcomes. Cancers (Basel). 2024;16(13):2371."},{"issue":"5","key":"bib6","series-title":"Endocr Relat Cancer","first-page":"R165","article-title":"Rare metastases of differentiated thyroid carcinoma: pictorial review","volume":"18","author":"Song","year":"2011","unstructured":"Song HJXue YLXu YHQiu ZLLuo QY.Rare metastases of differentiated thyroid carcinoma: pictorial review. Endocr Relat Cancer. 2011;18(5):R165-R174."},{"issue":"4","key":"bib7","series-title":"J Clin Endocrinol Metab","first-page":"1639","article-title":"Characteristics of follicular variant papillary thyroid carcinoma in a pediatric cohort","volume":"103","author":"Samuels","year":"2018","unstructured":"Samuels SLSurrey LFHawkes CPCharacteristics of follicular variant papillary thyroid carcinoma in a pediatric cohort. J Clin Endocrinol Metab. 2018;103(4):1639-1648."},{"issue":"6","key":"bib8","series-title":"Tumour Biol","first-page":"7797","article-title":"Predictive factors for recurrence of differentiated thyroid cancer in patients under 21 years of age and a meta-analysis of the current literature","volume":"37","author":"Qu","year":"2016","unstructured":"Qu NZhang LLu ZWPredictive factors for recurrence of differentiated thyroid cancer in patients under 21 years of age and a meta-analysis of the current literature. Tumour Biol. 2016;37(6):7797-7808."},{"issue":"8","key":"bib9","series-title":"Cancer Cytopathol","first-page":"594","article-title":"The role of thyroid FNA cytology in pediatric malignant lesions: an overview of the literature","volume":"125","author":"Rossi","year":"2017","unstructured":"Rossi EDMartini MCenci TCapodimonti SLarocca LM.The role of thyroid FNA cytology in pediatric malignant lesions: an overview of the literature. Cancer Cytopathol. 2017;125(8):594-603."},{"key":"bib10","series-title":"Clin Neurol Neurosurg","first-page":"107639","article-title":"Brain metastases of papillary thyroid carcinoma origin are derived from aggressive histologic variants and demonstrate similar adverse morphology in the metastatic lesion","volume":"227","author":"Gubbiotti","year":"2023","unstructured":"Gubbiotti MALivolsi V.Brain metastases of papillary thyroid carcinoma origin are derived from aggressive histologic variants and demonstrate similar adverse morphology in the metastatic lesion. Clin Neurol Neurosurg. 2023;227:107639."},{"issue":"6","key":"bib11","series-title":"Pediatr Blood Cancer","first-page":"e26966","article-title":"Noninvasive encapsulated follicular variant of papillary thyroid carcinoma: should it also be reclassified in children?","volume":"65","author":"Mariani","year":"2018","unstructured":"Mariani RAKadakia RArva NC.Noninvasive encapsulated follicular variant of papillary thyroid carcinoma: should it also be reclassified in children? Pediatr Blood Cancer. 2018;65(6):e26966."},{"issue":"5","key":"bib12","series-title":"Pediatr Blood Cancer","first-page":"e28957","article-title":"The incidence and risk factors for venous thromboembolism in adolescent and young adult oncology patients","volume":"68","author":"Hsiao","year":"2021","unstructured":"Hsiao WKrava EWee CPChau EJaffray J.The incidence and risk factors for venous thromboembolism in adolescent and young adult oncology patients. Pediatr Blood Cancer. 2021;68(5):e28957."},{"key":"bib13","series-title":"Am J Case Rep","first-page":"e939025","article-title":"Thyroglobulin as a rapid and cost-effective biomarker for diagnosis of thyroid carcinoma brain metastasis: a case report of a patient with metastatic Hurthle cell thyroid carcinoma","volume":"24","author":"Ntotsikas","year":"2023","unstructured":"Ntotsikas KLazarioti SDaraki VThyroglobulin as a rapid and cost-effective biomarker for diagnosis of thyroid carcinoma brain metastasis: a case report of a patient with metastatic Hurthle cell thyroid carcinoma. Am J Case Rep. 2023;24:e939025."},{"issue":"48","key":"bib14","series-title":"Med (Baltim)","first-page":"e28069","article-title":"Clinico-radiological features of brain metastases from thyroid cancer","volume":"100","author":"Kim","year":"2021","unstructured":"Kim SSKim SMPark MSuh SHAhn SJ.Clinico-radiological features of brain metastases from thyroid cancer. Med (Baltim). 2021;100(48):e28069."},{"key":"bib15","series-title":"Mol Cell Endocrinol","first-page":"22","article-title":"Traversing barriers\u2014how thyroid hormones pass placental, blood-brain and blood-cerebrospinal fluid barriers","volume":"458","author":"Landers","year":"2017","unstructured":"Landers KRichard K.Traversing barriers\u2014how thyroid hormones pass placental, blood-brain and blood-cerebrospinal fluid barriers. Mol Cell Endocrinol. 2017;458:22-28."},{"issue":"3","key":"bib16","series-title":"J Clin Endocrinol Metab","first-page":"594","article-title":"Calcitonin in plasma and cerebrospinal fluid from normal subjects and patients with medullary thyroid carcinoma: possible restriction of calcitonin by the blood-brain barrier","volume":"55","author":"Morimoto","year":"1982","unstructured":"Morimoto SNishimura JMiyauchi ACalcitonin in plasma and cerebrospinal fluid from normal subjects and patients with medullary thyroid carcinoma: possible restriction of calcitonin by the blood-brain barrier. J Clin Endocrinol Metab. 1982;55(3):594-596."},{"issue":"4","key":"bib17","series-title":"Clin Transl Oncol","first-page":"783","article-title":"Investigation of patent foramen ovale as a mechanism for brain metastasis in patients without prior lung involvement","volume":"23","author":"Levin-Epstein","year":"2021","unstructured":"Levin-Epstein RKumar PRusheen JInvestigation of patent foramen ovale as a mechanism for brain metastasis in patients without prior lung involvement. Clin Transl Oncol. 2021;23(4):783-787."},{"issue":"3","key":"bib18","series-title":"Eur Radiol","first-page":"365","article-title":"Isolated brain metastases of osteosarcoma in a patient presenting with a patent foramen ovale","volume":"7","author":"Menassa","year":"1997","unstructured":"Menassa LHaddad SAoun NSlaba SAtallah N.Isolated brain metastases of osteosarcoma in a patient presenting with a patent foramen ovale. Eur Radiol. 1997;7(3):365-367."},{"issue":"5","key":"bib19","series-title":"Nat Rev Endocrinol","first-page":"296","article-title":"The importance of the RET gene in thyroid cancer and therapeutic implications","volume":"17","author":"Salvatore","year":"2021","unstructured":"Salvatore DSantoro MSchlumberger M.The importance of the RET gene in thyroid cancer and therapeutic implications. Nat Rev Endocrinol. 2021;17(5):296-306."},{"issue":"12","key":"bib20","series-title":"Thyroid","first-page":"1771","article-title":"RET, NTRK, ALK, BRAF, and MET fusions in a large cohort of pediatric papillary thyroid carcinomas.","volume":"30","author":"Pekova","year":"2020","unstructured":"Pekova BSykorova VDvorakova SRET, NTRK, ALK, BRAF, and MET fusions in a large cohort of pediatric papillary thyroid carcinomas.Thyroid. 2020;30(12):1771-1780."},{"issue":"1","key":"bib1","series-title":"J Surg Res","first-page":"167","article-title":"Pediatric thyroid carcinoma: incidence and outcomes in 1753 patients","volume":"156","author":"Hogan","year":"2009","unstructured":"Hogan ARZhuge YPerez EAKoniaris LGLew JISola JE.Pediatric thyroid carcinoma: incidence and outcomes in 1753 patients. J Surg Res. 2009;156(1):167-172."},{"issue":"11","key":"bib2","series-title":"Thyroid","first-page":"1353","article-title":"Clinicopathologic characteristics of pediatric follicular variant of papillary thyroid carcinoma subtypes: a retrospective cohort study","volume":"32","author":"Halada","year":"2022","unstructured":"Halada SBaran JABauer AJClinicopathologic characteristics of pediatric follicular variant of papillary thyroid carcinoma subtypes: a retrospective cohort study. Thyroid. 2022;32(11):1353-1361."},{"issue":"1","key":"bib3","series-title":"Curr Opin Oncol","first-page":"59","article-title":"Differentiated thyroid cancer in children: diagnosis and management","volume":"20","author":"Dinauer","year":"2008","unstructured":"Dinauer CABreuer CRivkees SA.Differentiated thyroid cancer in children: diagnosis and management. 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Cancers (Basel). 2024;16(13):2371."},{"issue":"5","key":"bib6","series-title":"Endocr Relat Cancer","first-page":"R165","article-title":"Rare metastases of differentiated thyroid carcinoma: pictorial review","volume":"18","author":"Song","year":"2011","unstructured":"Song HJXue YLXu YHQiu ZLLuo QY.Rare metastases of differentiated thyroid carcinoma: pictorial review. Endocr Relat Cancer. 2011;18(5):R165-R174."},{"issue":"4","key":"bib7","series-title":"J Clin Endocrinol Metab","first-page":"1639","article-title":"Characteristics of follicular variant papillary thyroid carcinoma in a pediatric cohort","volume":"103","author":"Samuels","year":"2018","unstructured":"Samuels SLSurrey LFHawkes CPCharacteristics of follicular variant papillary thyroid carcinoma in a pediatric cohort. J Clin Endocrinol Metab. 2018;103(4):1639-1648."},{"issue":"6","key":"bib8","series-title":"Tumour Biol","first-page":"7797","article-title":"Predictive factors for recurrence of differentiated thyroid cancer in patients under 21 years of age and a meta-analysis of the current literature","volume":"37","author":"Qu","year":"2016","unstructured":"Qu NZhang LLu ZWPredictive factors for recurrence of differentiated thyroid cancer in patients under 21 years of age and a meta-analysis of the current literature. Tumour Biol. 2016;37(6):7797-7808."},{"issue":"8","key":"bib9","series-title":"Cancer Cytopathol","first-page":"594","article-title":"The role of thyroid FNA cytology in pediatric malignant lesions: an overview of the literature","volume":"125","author":"Rossi","year":"2017","unstructured":"Rossi EDMartini MCenci TCapodimonti SLarocca LM.The role of thyroid FNA cytology in pediatric malignant lesions: an overview of the literature. Cancer Cytopathol. 2017;125(8):594-603."},{"key":"bib10","series-title":"Clin Neurol Neurosurg","first-page":"107639","article-title":"Brain metastases of papillary thyroid carcinoma origin are derived from aggressive histologic variants and demonstrate similar adverse morphology in the metastatic lesion","volume":"227","author":"Gubbiotti","year":"2023","unstructured":"Gubbiotti MALivolsi V.Brain metastases of papillary thyroid carcinoma origin are derived from aggressive histologic variants and demonstrate similar adverse morphology in the metastatic lesion. Clin Neurol Neurosurg. 2023;227:107639."},{"issue":"6","key":"bib11","series-title":"Pediatr Blood Cancer","first-page":"e26966","article-title":"Noninvasive encapsulated follicular variant of papillary thyroid carcinoma: should it also be reclassified in children?","volume":"65","author":"Mariani","year":"2018","unstructured":"Mariani RAKadakia RArva NC.Noninvasive encapsulated follicular variant of papillary thyroid carcinoma: should it also be reclassified in children? Pediatr Blood Cancer. 2018;65(6):e26966."},{"issue":"5","key":"bib12","series-title":"Pediatr Blood Cancer","first-page":"e28957","article-title":"The incidence and risk factors for venous thromboembolism in adolescent and young adult oncology patients","volume":"68","author":"Hsiao","year":"2021","unstructured":"Hsiao WKrava EWee CPChau EJaffray J.The incidence and risk factors for venous thromboembolism in adolescent and young adult oncology patients. Pediatr Blood Cancer. 2021;68(5):e28957."},{"key":"bib13","series-title":"Am J Case Rep","first-page":"e939025","article-title":"Thyroglobulin as a rapid and cost-effective biomarker for diagnosis of thyroid carcinoma brain metastasis: a case report of a patient with metastatic Hurthle cell thyroid carcinoma","volume":"24","author":"Ntotsikas","year":"2023","unstructured":"Ntotsikas KLazarioti SDaraki VThyroglobulin as a rapid and cost-effective biomarker for diagnosis of thyroid carcinoma brain metastasis: a case report of a patient with metastatic Hurthle cell thyroid carcinoma. Am J Case Rep. 2023;24:e939025."},{"issue":"48","key":"bib14","series-title":"Med (Baltim)","first-page":"e28069","article-title":"Clinico-radiological features of brain metastases from thyroid cancer","volume":"100","author":"Kim","year":"2021","unstructured":"Kim SSKim SMPark MSuh SHAhn SJ.Clinico-radiological features of brain metastases from thyroid cancer. Med (Baltim). 2021;100(48):e28069."},{"key":"bib15","series-title":"Mol Cell Endocrinol","first-page":"22","article-title":"Traversing barriers\u2014how thyroid hormones pass placental, blood-brain and blood-cerebrospinal fluid barriers","volume":"458","author":"Landers","year":"2017","unstructured":"Landers KRichard K.Traversing barriers\u2014how thyroid hormones pass placental, blood-brain and blood-cerebrospinal fluid barriers. Mol Cell Endocrinol. 2017;458:22-28."},{"issue":"3","key":"bib16","series-title":"J Clin Endocrinol Metab","first-page":"594","article-title":"Calcitonin in plasma and cerebrospinal fluid from normal subjects and patients with medullary thyroid carcinoma: possible restriction of calcitonin by the blood-brain barrier","volume":"55","author":"Morimoto","year":"1982","unstructured":"Morimoto SNishimura JMiyauchi ACalcitonin in plasma and cerebrospinal fluid from normal subjects and patients with medullary thyroid carcinoma: possible restriction of calcitonin by the blood-brain barrier. J Clin Endocrinol Metab. 1982;55(3):594-596."},{"issue":"4","key":"bib17","series-title":"Clin Transl Oncol","first-page":"783","article-title":"Investigation of patent foramen ovale as a mechanism for brain metastasis in patients without prior lung involvement","volume":"23","author":"Levin-Epstein","year":"2021","unstructured":"Levin-Epstein RKumar PRusheen JInvestigation of patent foramen ovale as a mechanism for brain metastasis in patients without prior lung involvement. Clin Transl Oncol. 2021;23(4):783-787."},{"issue":"3","key":"bib18","series-title":"Eur Radiol","first-page":"365","article-title":"Isolated brain metastases of osteosarcoma in a patient presenting with a patent foramen ovale","volume":"7","author":"Menassa","year":"1997","unstructured":"Menassa LHaddad SAoun NSlaba SAtallah N.Isolated brain metastases of osteosarcoma in a patient presenting with a patent foramen ovale. 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