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Colegio de Medicina Interna de México.

2017, Número 4

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Med Int Mex 2017; 33 (4)


Metástasis cerebrales en pacientes con cáncer de tiroides

Cacho-Díaz B, Spínola-Maroño H, Granados-García M, Reyes-Soto G, Cuevas-Ramos D, Herrera-Gómez A, Olvera-Manzanilla E

Idioma: Español
Referencias bibliográficas: 45
Paginas: 452-458
Archivo PDF: 208.46 Kb.


RESUMEN

Antecedentes: el cáncer es una de las primeras causas de morbilidad y mortalidad en el mundo; la neoplasia endocrinológica más frecuente es el cáncer de tiroides. A pesar que la mayoría de los pacientes con cáncer de tiroides tienen buen pronóstico, 10 a 15% de los pacientes muestra recurrencia de la enfermedad e incluso 5% padece metástasis a distancia. Las metástasis cerebrales del cáncer de tiroides son raras y habitualmente conllevan mal pronóstico.
Objetivo: describir las características demográficas y radiológicas, así como el pronóstico clínico de pacientes con cáncer de tiroides que requirieron consulta neurológica.
Material y Método: estudio prospectivo observacional en el que se incluyeron pacientes atendidos en un centro de referencia de tercer nivel con cáncer de tiroides que requirieron consulta neurológica entre enero de 2010 y enero de 2016. Se estudiaron las concentraciones séricas de tiroglobulina, TSH y anticuerpos anti-tiroglobulina, como se ha sugerido previamente.
Resultados: encontramos siete pacientes con metástasis cerebrales por cáncer de tiroides y las comparamos con registros encontrados en la bibliografía. El género masculino, la edad avanzada y las concentraciones elevadas de tiroglobulina se asociaron con mayor frecuencia de metástasis a distancia de cáncer de tiroides.
Conclusiones: las metástasis cerebrales de cáncer de tiroides son complicaciones poco frecuentes con pronóstico adverso. La tiroglobulina es un marcador tumoral muy útil para el seguimiento de pacientes con cáncer de tiroides ya que está elevada en pacientes con actividad sistémica y muy elevada en sujetos con metástasis cerebrales.


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