Recombinant Human TSH Increases Uptake and Effective Half-life of Radioiodine in Thyroid Hormone Secreting Metastases of Follicular Thyroid Cancer

 

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Abstract

Follicular thyroid cancer with thyroid hormone secreting metastases is an extremely rare condition, with only a few cases reported world-wide.

We here present the case of a 64-year-old female patient affected by follicular thyroid cancer with extensive thyroid hormone secreting metastases leading to TSH-suppression.

We have also summarized the relevant diagnostic and therapeutic approaches and describe, for the first time, the effects of rhTSH-application in this rare tumor entity.

In this patient, we found that rhTSH increased ¹³¹I-uptake into the thyroid hormone secreting metastases and prolonged the effective half-life of ¹³¹I. These effects of rhTSH should be considered when fixed activities of ¹³¹I are prescribed.

• References

• 1 Als C, Gedeon P, Rösler H et al. Survival analysis of 19 patients with toxic thyroid carcinoma. J Clin Endocrinol Metab 2002; 87: 4122-4127
  CrossrefPubMedGoogle Scholar
• 2 Baumann K, Weitzel M, Bürgi H. Hormonproduzierendes Schilddrüsenkarzinom mit Hyperthyreose. Schweiz. Med Wschr 1979; 109: 309-314
  PubMedGoogle Scholar
• 3 Cooper DS, Doherty GM, Haugen BR et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2009; 19: 1167-1214
  Google Scholar
• 4 Federman D. Actively functioning thyroid cancer metastases despite hyperfunctioning thyroid. Medicine 1964; 43: 267-274
  PubMedGoogle Scholar
• 5 Grayzel EF, Bennett B. Graves’ disease, follicular thyroid carcinoma and functioning pulmonary metastases. Cancer 1979; 43: 1885-1887
  CrossrefPubMedGoogle Scholar
• 6 Hänscheid H, Lassmann M, Luster M et al. Blood dosimetry from a single measurement of the whole body radioiodine retention in patients with differentiated thyroid carcinoma. Endocr Relat Cancer 2009; 16: 1283-1289
  CrossrefPubMedGoogle Scholar
• 7 Leiter L, Seidlin SM, Marinelli LD et al. Adenocarcinoma of the thyroid with hyperthyroidism and functional metastases. J Clin Endocrinol 1946; 6: 247-261
  CrossrefPubMedGoogle Scholar
• 8 Nemec J, Zemon V, Nahodil V et al. Metastatic thyroid cancer with severe hyperthyroidism mimicking independent functioning thyroid adenoma, showing transition to water-clear-tumor. Endokrinology 1980; 75: 197-204
  PubMedGoogle Scholar
• 9 Pacini F, Castagna MG, Brilli L et al. Differentiated thyroid cancer: ESMO clinical recommendations for diagnosis, treatment and follow-up. Ann Oncol 2009; 20: 143-146
  PubMedGoogle Scholar
• 10 Pitoia F, Ward L, Wohllk N et al. Recommendations of the Latin American Thyroid Society on diagnosis and management of differentiated thyroid cancer. Arq Bras Endocrinol Metabol 2009; 53: 884-887
  CrossrefPubMedGoogle Scholar
• 11 Stabin MG, Sparks RB, Crowe E. OLINDA/EXM: the second-generation personal computer software for internal dose assessment in nuclear medicine. J Nucl Med 2005; 46: 1023-1027
  PubMedGoogle Scholar
• 12 Verburg FA, Hänscheid H, Biko J et al. Dosimetry-guided high-activity ¹³¹I therapy in patients with advanced differentiated thyroid carcinoma: initial experience. Eur J Nucl Med Mol Imaging 2010; 37: 896-903
  CrossrefPubMedGoogle Scholar
• 13 Zanotti-Fregonara P, Hidie E. On the effectiveness of recombinant human TSH as a stimulating agent for ¹³¹I treatment of metastatic differentiated thyroid cancer. Eur J Nucl Med Mol Imaging 2010; 31: 2264-2266
  PubMedGoogle Scholar