Int J Thyroidol.  2020 May;13(1):60-63. 10.11106/ijt.2020.13.1.60.

Successful Treatment of Cavernous Sinus Metastasis from Follicular Thyroid Carcinoma with Lenvatinib

• Lee TS
• See A
• Lim C
• Huang XY

• KMID: 2502263
• DOI: http://doi.org/10.11106/ijt.2020.13.1.60

Abstract

Radioiodine-refractory distant metastases in well-differentiated thyroid carcinomas are rare but pose a significant diagnostic and management challenge. Follicular thyroid carcinoma which is a type of well-differentiated carcinoma, is known for its hematogenous spread. Various sites of distant metastasis have been described. We report the first-ever case of radioiodine-refractory metastasis at the cavernous sinus, arising from follicular thyroid carcinoma. The atypical site of metastasis and management complexity of radioiodine-refractory disease is discussed in this article.

Keyword

Follicular thyroid carcinoma; Metastases; Lenvatinib; Cavernous sinus

Figure

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  Fig. 1 (A) PET-CT showing an intensely FDG-avid lesion in the left cavernous sinus extending into the left sphenoid sinus, and the axial (B) and coronal (C) cuts of CT paranasal sinuses showing a soft tissue lesion in left cavernous sinus and bilateral sphenoid sinuses with bony erosion.

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  Fig. 2 Interval PET-CT after treatment with four weeks of Lenvatinib, showing significant reduction in size and FDG-avidity of metastasis.

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