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Radioactive iodine therapy in poorly differentiated thyroid cancer


Background A 55-year-old male was diagnosed with poorly differentiated thyroid cancer after total thyroidectomy, which was performed because of progressive enlargement of a dominant thyroid nodule. He developed an early cervical recurrence that was treated with modified neck dissection. He subsequently developed biopsy-proven progressive pulmonary metastases.

Investigations Neck and chest CT scans, laboratory tests, CT-guided fine-needle aspiration biopsy, [18F]-2-fluoro-2-deoxy-D-glucose-PET scan, lesional dosimetry using 124I PET scan, diagnostic radioactive iodine (RAI) scanning, whole-body and blood RAI dosimetry, and single-photon-emission CT.

Diagnosis Stage IV poorly differentiated thyroid cancer.

Management Surgical resection of cervical recurrence, RAI therapy.

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Figure 1: 124I PET-CT scan of the patient.
Figure 2: 131I post-therapy scan.
Figure 3: 131I post-therapy transaxial single-photon-emission CT.


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Correspondence to R Michael Tuttle.

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Competing interests

RM Tuttle has received honaria and research support from Genzyme. The other authors declared they have no competing interests.

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Tuttle, R., Grewal, R. & Larson, S. Radioactive iodine therapy in poorly differentiated thyroid cancer. Nat Rev Clin Oncol 4, 665–668 (2007).

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