Abstract
A 55-year-old man presents with widespread bone metastases and markedly elevated serum thyroglobulin from a follicular thyroid carcinoma. He has already undergone thyroidectomy, radioiodine ablation, external radiation therapy, and surgical procedures for spinal metastases and also has been on inadequate doses of levothyroxine based on several measurements of TSH levels that were inappropriately within the normal range. Questions faced included how to best demonstrate the sites and extent of residual disease and how to most effectively treat them. The approach included iodine-124 PET scanning and associated iodine-124 lesional dosimetry followed by treatment with relatively high activity iodine-131 that resulted in a good clinical response. Based upon risk stratification according to the 2014 ATA Guidelines, this patient was clearly a high-risk patient with a poor predicted outcome, and imaging studies confirmed a structurally incomplete response to his initial therapy. While full cure of this patient’s disease is unlikely, the plan for dosimetric radioiodine activities and other adjunctive therapies is presented which should both reduce morbidity from his bone lesions and delay his mortality from the disease.
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Wartofsky, L. (2016). A Patient with Bone Metastases from Follicular Carcinoma of the Thyroid. In: Cooper, D., Durante, C. (eds) Thyroid Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-22401-5_28
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DOI: https://doi.org/10.1007/978-3-319-22401-5_28
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