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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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). https://doi.org/10.1038/ncponc0979