{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T05:03:38Z","timestamp":1779685418393,"version":"3.53.1"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Papillary thyroid carcinoma (PTC) usually has a favorable prognosis, the concurrent occurrence of brain and lung metastases is extremely rare, thus such cases have significant clinical reporting value. We report a case of a patient with multifocal PTC who presented with delayed multiple metastases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>In January 2025, a 61-year-old female suddenly developed speech impairment and right limb weakness without an obvious cause. Upon reviewing her medical history, it was found that she had undergone a total thyroidectomy six years earlier because of multiple papillary thyroid carcinomas. Upon admission, relevant examinations were performed: cranial MRI revealed a solitary mass in the left frontal lobe, and a chest CT revealed multiple nodules in both lungs. The postoperative pathological examination of the brain lesion and bronchoscopic biopsy of the mediastinal lymph nodes revealed metastatic thyroid cancer (Pax-8, Tg, and TTF-1 positive). Diagnostic \u00b9\u00b3\u00b9I whole-body scan after high-dose radioactive iodine treatment (180 mCi) revealed no significant radioactive isotope uptake by the lung metastases, indicating a radioactive iodine-resistant disease. Subsequently, three cycles of systemic chemotherapy (albumin-bound paclitaxel combined with carboplatin) were tried, but they were discontinued because of extreme toxicity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Treatment and results<\/jats:title>\n                    <jats:p>The patient underwent surgical resection of brain metastases, and then switched to the multi-kinase inhibitor anlotinib due to poor chemotherapy tolerance. After approximately 10 weeks of anlotinib treatment, the first CT assessment showed a partial response, with the lung metastases shrinking and partially resolving. The most recent follow-up CT (in March 2026) confirmed that the remission was ongoing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case indicates that PTC can result in uncommon, delayed, and numerous distant metastases even years after radical surgery. This highlights the importance of life-long surveillance, including chest and crinial imagings. The partial remission with anlotinib underscores its value as a therapeutic option in this setting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1849526","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T04:36:11Z","timestamp":1779683771000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Papillary thyroid carcinoma with brain and lung metastases: a case report"],"prefix":"10.3389","volume":"16","author":[{"given":"Ying","family":"Zhao","sequence":"first","affiliation":[{"name":"The First Clinical Medical College, Lanzhou University","place":["Lanzhou, Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohua","family":"Chen","sequence":"additional","affiliation":[{"name":"The First Clinical Medical College, Lanzhou University","place":["Lanzhou, Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Bai","sequence":"additional","affiliation":[{"name":"The First Clinical Medical College, Lanzhou University","place":["Lanzhou, Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shujun","family":"Guo","sequence":"additional","affiliation":[{"name":"The First Clinical Medical College, Lanzhou University","place":["Lanzhou, Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Gao","sequence":"additional","affiliation":[{"name":"The First Clinical Medical College, Lanzhou University","place":["Lanzhou, Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohan","family":"Liu","sequence":"additional","affiliation":[{"name":"The First Clinical Medical College, Lanzhou University","place":["Lanzhou, Gansu, 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