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  • 期刊

Discrepancy of Diagnostic and Post-Therapeutic Radioiodine Whole Body Scans in a Follicular Thyroid Carcinoma Patient with Multiple Bony Metastases

濾泡型甲狀腺癌合併多處骨轉移病人診斷性與治療後碘-131全身掃描結果不一致

摘要


大劑量碘-131是甲狀腺癌骨轉移的主要治療方式,但其治癒率仍有限,本文描述一位40歲慮泡型甲狀腺癌經甲狀腺切除後女性病人,接受碘-131全身掃描發現有多處骨轉移。病人隨即接受200mCi碘-131治療,但治療後之碘-131全身掃描與先前小劑量碘-131診斷性掃描結果明顯不一致。病人在往後6個月及2年之碘-131全身掃描均無骨轉移病灶發現,一系列停用甲狀腺素後之血中甲狀腺素後之血中甲狀腺球蛋白?測定亦為陰性。綜合臨床病程與相關文獻回顧,此病人係早期骨轉移並為大劑量碘-131治療所控制的可能性較大。

並列摘要


A large amount of radioiodine-131 (131I) is the main choice for treatment of follicular thyroid carcinoma with multiple bony metastases. However, the curative rate is not encouraging. A 40-year-old woman who had received a thyroidectomy due to follicular thyroid cancer was referred to our department for the 131I cancer workup. She did not have bone pain or other clinical manifestations regarding bony metastases. Serum thyroglobulin (Tg) value in thyroxine withdrawal was 29.9 ng/mL. The diagnostic 131I whole body scan (WBS, 2 mCi) showed multiple bony metastases. A 200 mCi of 131I was thus given. Interestingly, the image pattern of the post-therapeutic WBS was quite different from that seen on the diagnostic scan, which showed a large decrease in numbers of bony metastases. Therapeutic and/or stunning effects of the diagnostic 131I might contribute to the discrepancy. Negative 131I WBS with stimulated serum Tg values less than 2 ng/mL, however, were found at 6 months and at 2 years after therapy.

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