Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

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.

This is a preview of subscription content

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.

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.


  1. 1

    Burch HB (1995) Evaluation and management of the solid thyroid nodule. Endocrinol Metab Clin North Am 24: 663–710

    CAS  Article  Google Scholar 

  2. 2

    Garber JR (2006) Thyroid nodules 2006: managing what has been known for over 50 years. Hormones (Athens) 5: 179–186

    Article  Google Scholar 

  3. 3

    Frates MC et al. (2005) Management of thyroid nodules detected at US: Society of Radiologists in Ultrasound consensus conference statement—thyroid nodule shape and prediction of malignancy. Radiology 237: 794–800

    Article  Google Scholar 

  4. 4

    Ogilvie JB et al. (2006) Current status of fine needle aspiration for thyroid nodules. Adv Surg 40: 223–238

    Article  Google Scholar 

  5. 5

    Mazzaferri EL et al. (2001) Clinical review 128: current approaches to primary therapy for papillary and follicular thyroid cancer. J Clin Endocrinol Metab 86: 1447–1463

    CAS  Article  Google Scholar 

  6. 6

    Cooper DS et al. (2006) Management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 16: 109–142

    Article  Google Scholar 

  7. 7

    Patel KN et al. (2006) Poorly differentiated and anaplastic thyroid cancer. Cancer Control 13: 119–128

    Article  Google Scholar 

  8. 8

    Rosai J (2004) Poorly differentiated thyroid carcinoma: introduction to the issue, its landmarks, and clinical impact. Endocr Pathol 15: 293–296

    Article  Google Scholar 

  9. 9

    Volante M et al. (2004) Poorly differentiated carcinomas of the thyroid with trabecular, insular, and solid patterns: a clinicopathologic study of 183 patients. Cancer 100: 950–957

    Article  Google Scholar 

  10. 10

    Hiltzik D et al. (2006) Poorly differentiated thyroid carcinomas defined on the basis of mitosis and necrosis: a clinicopathologic study of 58 patients. Cancer 106: 1286–1295

    Article  Google Scholar 

  11. 11

    Robbins RJ et al. (2004) Factors influencing the basal and recombinant human thyrotropin-stimulated serum thyroglobulin in patients with metastatic thyroid carcinoma. J Clin Endocrinol Metab 89: 6010–6016

    CAS  Article  Google Scholar 

  12. 12

    Lee N et al. (2006) The role of external beam radiotherapy in the treatment of papillary thyroid cancer. Endocr Relat Cancer 13: 971–977

    Article  Google Scholar 

  13. 13

    Tuttle M et al. (2004) Challenging cases in thyroid cancer: a multidisciplinary approach. Eur J Nucl Med Mol Imaging 31: 605–612

    Article  Google Scholar 

  14. 14

    Lind P et al. (2006) Respective roles of thyroglobulin, radioiodine imaging, and positron emission tomography in the assessment of thyroid cancer. Semin Nucl Med 36: 194–205

    Article  Google Scholar 

  15. 15

    Robbins RJ et al. (2006) Real-time prognosis for metastatic thyroid carcinoma based on 2-[18F]fluoro-2-deoxy-D-glucose-positron emission tomography scanning. J Clin Endocrinol Metab 91: 498–505

    CAS  Article  Google Scholar 

  16. 16

    Sgouros G et al. (2004) Patient-specific dosimetry for 131I thyroid cancer therapy using 124I PET and 3-dimensional-internal dosimetry (3D-ID) software. J Nucl Med 45: 1366–1372

    CAS  PubMed  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to R Michael Tuttle.

Ethics declarations

Competing interests

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

Rights and permissions

Reprints and Permissions

About this article

Cite this article

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

Download citation

Further reading


Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing