Diagnosis and management of brain metastasis from thyroid cancer

The brain is an uncommon location for metastatic spread from thyroid cancer. Given the rarity of the condition, the data regarding various management options for such patients are suboptimal. Radioactive iodine is seldom useful for brain metastases owing to variable uptake and unclear benefit. Surgical resection and stereotactic radiation remain the first-line treatment options for a limited number of brain metastases from thyroid cancer, as they not only provide local control and symptomatic relief but can also improve survival. Whole-brain radiation therapy has been used for patients with multiple brain metastases but has largely fallen out of favor due to the availability of more targeted and tolerable options. Systemic therapy with kinase inhibitors is a novel and promising area of research in this field, with an increased utilization of molecular testing to identify targetable mutations. Treatment plans for patients with brain metastases from thyroid cancer should be highly individualized and tailored to the specific patient by a multidisciplinary care team.