Brain metastasis from medullary thyroid carcinoma

Revised American Thyroid Association Guidelines for the Management of Medullary Thyroid Carcinoma

“…Most asymptomatic patients with elevated serum Ctn levels and occult metastatic disease are not surgical candidates because natural history studies indicate that many of them have a relatively good prognosis, especially if the Ctn and CEA doubling times exceed 2 years (313)(314)(315) Clinically apparent brain metastases occur in 1%-5% of patients with MTC. Börcek and associates found only 10 reported cases in a literature review; however, the prevalence is almost certainly underreported due to the infrequent use of central nervous system imaging in patients with advanced MTC (316). Patients with widespread metastases and neurological symptoms should be evaluated for the presence of brain metastases.…”

Systemic and CNS Activity of Selective RET Inhibition With Selpercatinib (LOXO-292) in a Patient With RET-Mutant Medullary Thyroid Cancer With Extensive CNS Metastases

“…1 The CNS is a rare site of metastasis in MTC, with < 15 cases reported in the medical literature; however, the prevalence may be underreported because of the infrequent use of CNS imaging in patients with MTC. 1 , 2 The optimal treatment approach for patients with MTC with CNS involvement is currently unknown. Although surgical resection, radiation therapy, or stereotactic radiosurgery (SRS) may improve local disease control in some patients, most still succumb to their disease within months after the diagnosis of CNS metastases.…”

Response to Selective RET Inhibition With LOXO-292 in a Patient With RET Fusion-Positive Lung Cancer With Leptomeningeal Metastases

“…33 Although the frequency at which intracranial metastases present is lower for many of these other cancers compared with NSCLCs, metastatic disease in the CNS can occur in some cases. 34…”