Papillary thyroid carcinoma (PTC) is the most common type of well-differentiated thyroid cancer and usually has a favorable prognosis with a low risk of metastasis. However, distant metastasis significantly worsens the prognosis. Brain metastasis of papillary thyroid carcinoma is very rare, and there is currently no standardized treatment protocol for this condition. Case Presentation: A 56-year-old woman was admitted to our hospital 7 years after undergoing total thyroidectomy for primary papillary thyroid carcinoma, presenting with neurological symptoms including decreased mental responsiveness, memory impairment, and motor aphasia. Brain MRI revealed an abnormal mass in the left frontal lobe with extensive surrounding edema. The patient underwent left fronto-temporal craniotomy with complete tumor resection. Postoperatively, the patient showed significant neurological improvement and was started on oral thyroxine replacement therapy. Innovation and Significance: This case provides several noteworthy contributions: (1) It is one of the few reported cases of a single frontal lobe metastatic lesion occurring more than 7 years after primary tumor treatment; (2) It establishes a standardized approach to comprehensive pre- and postoperative neurological assessments; (3) It challenges the traditional view that brain metastases in PTC are almost always associated with extensive systemic dissemination; (4) It provides detailed immunohistochemical characterization of both the primary tumor and the metastatic site. Conclusion: PTC is the most common type of thyroid cancer, typically slow-growing with generally favorable outcomes. Metastases most commonly involve regional lymph nodes, with occasional distant metastases to the lungs and bones. Brain metastases from PTC are extremely rare. In this paper, we present a case of pathologically confirmed PTC brain metastasis in the left frontal lobe and review the available literature on its clinical significance.

This study compared clinical and safety outcomes of radioactive iodine therapies administered after thyroid hormone withdrawal (THW) versus recombinant human thyrotropin (rhTSH) in patients with differentiated thyroid cancer and distant metastases, using both patient- and therapy-based analyses. Methods: Patient-based analyses included 352 patients classified into the THW-only (n = 259), rhTSH-only (n = 40), or mixed (n = 53) groups, whereas therapy-based analyses included 564 radioactive iodine therapies administered after THW (n = 459) or rhTSH (n = 105). Overall survival and disease-specific survival were assessed at the patient level, whereas imaging-based response, change in thyroglobulin after therapy (biochemical response), and laboratory-based safety outcomes were evaluated at the therapy level. Results: Overall survival and disease-specific survival did not differ significantly among the 3 patient groups (all P > 0.25). Imaging- and biochemical-response outcomes also were comparable between groups who received RAI therapy after THW and rhTSH (both P > 0.05), and the preparation method was not significantly associated with either response outcome. In contrast, liver function abnormalities and the occurrence of at least 1 prespecified laboratory-based safety outcome were significantly more frequent after THW (both P < 0.001). Conclusion: rhTSH and THW were associated with comparable survival and treatment responses in patients with differentiated thyroid cancer with distant metastases, whereas laboratory-based safety outcomes were more frequent after THW preparation. These findings strengthen multicenter real-world evidence supporting rhTSH as an alternative to THW for select patients, particularly when minimizing prolonged hypothyroidism is important for individualized treatment planning.

The association between lymphovascular invasion (LVI) and outcomes in dogs with thyroid carcinoma is inadequately described, and a standardized definition of LVI is lacking. This study's objectives were to histopathologically and immunohistochemically characterize LVI and to evaluate associated clinical outcomes in dogs with thyroid carcinoma. Inclusion criteria were: dogs that underwent thyroidectomy for thyroid carcinoma with available histopathology samples, and a minimum of 1-year postoperative follow-up data or follow-up to death. Thirty dogs with 35 distinct tumours, including 26 follicular and nine medullary, were evaluated. LVI was characterized as intracapsular endothelialized tumour emboli (without adhered fibrin) in 26 samples, intracapsular tumour emboli with adhered fibrin in seven samples, extracapsular tumour emboli without adhered fibrin in 10 samples, and extracapsular tumour emboli with endothelial disruptions and adhered fibrin in three samples. CD31 and Prox1 positive vessels contained endothelialized tumour thrombi in 17 and one sample, respectively. Extracapsular invasion with (non-endothelialized) and without (endothelialized) associated fibrin were associated with a 10-fold (p = 0.001) and 3-fold (p = 0.013) increase in the likelihood of death, respectively. No significant difference in the likelihood of death was noted between cases of extracapsular invasion with or without fibrin (p = 0.31). Intracapsular tumour thrombi with or without associated fibrin and non-endothelialized tumour thrombi were not associated with outcomes in this cohort. These results support that in dogs with thyroid carcinoma, extracapsular LVI with or without associated fibrin thrombi, but not intracapsular LVI, is associated with worse outcomes. Further study is warranted on a larger population of dogs with standardized treatment and follow-up.

Visual in-context learning (ICL) enables medical image segmentation models to adapt to new tasks using only a small set of annotated support images, without additional model fine-tuning. This makes visual ICL promising for clinical deployment, yet a fundamental limitation remains. Current ICL models lack the intrinsic ability to adaptively integrate supports based on their relevance to the query. By either aggregating supports uniformly or relying on external retrieval, these methods limit query-aware support integration within the model itself. We introduce Dual-DSA (Dual-Dynamic Support Alignment), a reliability-aware visual ICL framework that dynamically integrates supports at the patch and support-set levels. At the patch level, DynPatch-Align selectively attends to relevant support regions for each query location, enabling fine-grained contextual alignment. At the support set level, evidential fusion integrates support-conditioned predictions based on uncertainty and consistency, and provides an Aggregate Evidential Confidence Score for reliability assessment. Together, these mechanisms enable intrinsic, query-adaptive support integration across both levels. Extensive experiments on 11 medical imaging datasets across endoscopy, breast ultrasound, and thyroid ultrasound show that Dual-DSA achieves strong full-coverage performance, obtaining the best Dice score on 8 out of 11 datasets and consistently outperforming its attention-based ICL backbone. Furthermore, the derived confidence scores correlate with segmentation quality and enable confidence-based rejection to improve retained-case performance, providing a practical mechanism for quality control in clinical workflows.

Accurate estimation of the postmortem interval (PMI) remains one of the major challenges in forensic medicine. Recent advances in molecular biology have introduced novel approaches for the evaluation of mRNA degradation; however, reliable interpretation of postmortem data requires a stable endogenous reference for normalization. Using real-time quantitative PCR (RT-qPCR), we analyzed GAPDH mRNA degradation in psoas major muscle and thyroid gland tissues through two experimental approaches: (1) time- and temperature-stability experiments and (2) analysis of cadaveric samples collected at different PMIs. For this purpose, we used our in-house-developed probe targeting the 5' region of the GAPDH mRNA. The obtained data demonstrated relative stability of GAPDH mRNA in both tissue types regardless of storage temperature. Overall, our findings indicate high stability and reproducibility of the applied assay, supporting the potential use of the targeted 5' GAPDH region as an endogenous reference for normalization in postmortem RT-qPCR studies in forensic and legal medicine.