—Hay and coworkers have just published a comprehensive study of 859 patients with papillary carcinoma of the thyroid gland.1 Of a subset of 800 patients, they noted distant metastatic lesions in 40 patients (5%).
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Of these 40 patients, six patients (15%) were reported to have brain involvement, and five others (12.5%) had spinal cord metastases. This presentation is, therefore, as in our experience,2 quite uncommon, even in a referral-type population, as seen in the Mayo Clinic. Note that brain metastases in follicular thyroid carcinoma are also rare.3 We cannot comment on the age and sex of this type of patient due to our small number of patients and the selection bias introduced by the population of a veterans hospital.
In the study by Hay and coworkers, both brain and spinal cord metastases were associated with high mortality, second only