Abstract
During the follow-up of a patient with differentiated thyroid carcinoma, Tg elevation without iodine uptake on WB scan was noted. She received an empiric dose of radioiodine to evaluate the possible Tg production site; however, no evidence of uptake was found. PET/CT scan showed pulmonary nodules, some of which were FDG avid. Finally, sorafenib treatment was initiated which is currently at the 22nd month of the follow-up.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Haugen BR, Sawka AM, Alexander EK, Bible KC, Caturegli P, Doherty GM, et al. American Thyroid Association guidelines on the management of thyroid nodules and differentiated thyroid cancer task force review and recommendation on the proposed renaming of encapsulated follicular variant papillary thyroid carcinoma without invasion to noninvasive follicular thyroid neoplasm with papillary-like nuclear features. Thyroid. 2017;27:481–3. https://doi.org/10.1089/thy.2016.0628.
Ma C, Kuang A, Xie J, Ma T. Possible explanations for patients with discordant findings of serum thyroglobulin and 131I whole-body scanning. J Nucl Med. 2005;46:1473–80.
Pineda JD, Lee T, Ain K, Robbins J. Iodine-131 therapy for thyroid cancer patients with elevated thyroglobulin and negative diagnostic scan. J Clin Endocrinol Metab. 1995;80:1488–92.
de Keizer B, Koppeschaar HP, Zelissen PM, et al. Efficacy of high therapeutic doses of iodine-131 in patients with differentiated thyroid cancer and detectable serum thyroglobulin. Eur J Nucl Med. 2001;28:198–202.
Pacini L, Agate R, Elisei M. Outcome of differentiated thyroid cancer with detectable serum Tg and negative 131I whole body scan: comparison of patients treated with high 131I activities versus untreated patients. J Clin Endocrinol Metab. 2001;86:4092–7.
Koh JM, Kim ES, Ryu JS, et al. Effects of therapeutic doses of 131I in thyroid papillary carcinoma patients with elevated thyroglobulin level and negative 131I whole-body scan: comparative study. Clin Endocrinol. 2003;58:421–7.
Kabasakal L, Selçuk NA, Shafipour H, Ozmen O, Onsel C, Uslu I. Treatment of iodine-negative thyroglobulin-positive thyroid cancer: differences in outcome in patients with macrometastases and patients with micrometastases. Eur J Nucl Med Mol Imaging. 2004;31:1500–4.
Ma C, Xie J, Kuang A. Is empiric 131I therapy justified for patients with positive thyroglobulin and negative 131I whole-body scanning results? J Nucl Med. 2005;46:1164–70.
Chao M. Management of differentiated thyroid cancer with rising thyroglobulin and negative diagnostic radioiodine whole body scan. Clin Oncol (R Coll Radiol). 2010;22:438–47. https://doi.org/10.1016/j.clon.2010.05.005.
Vural GU, Akkas BE, Ercakmak N, Basu S, Alavi A. Prognostic significance of FDG PET/CT on the follow-up of patients of differentiated thyroid carcinoma with negative 131I whole-body scan and elevated thyroglobulin levels: correlation with clinical and histopathologic characteristics and long-term follow-up data. Clin Nucl Med. 2012;37:953–9. https://doi.org/10.1097/RLU.0b013e31825b205.
Ozkan E, Aras G, Kucuk NO. Correlation of 18F-FDG PET/CT findings with histopathological results in differentiated thyroid cancer patients who have increased thyroglobulin or antithyroglobulin antibody levels and negative 131I whole-body scan results. Clin Nucl Med. 2013;38:326–31. https://doi.org/10.1097/RLU.0b013e318286827b.
Pacini F. Which patient with thyroid cancer deserves systemic therapy and when? Best Pract Res Clin Endocrinol Metab. 2017;31:291–4. https://doi.org/10.1016/j.beem.2017.08.001.
Thomas L, Lai SY, Dong W, Feng L, Dadu R, Regone RM, Cabanillas ME. Sorafenib in metastatic thyroid cancer: a systematic review. Oncologist. 2014;19:251–8. https://doi.org/10.1634/theoncologist.2013-0362.
Viola D, Valeria L, Molinaro E Agate L, Bottici V, Biagini A, et al. Treatment of advanced thyroid cancer with targeted therapies: ten years of experience. Endocr Relat Cancer. 2016;23:R185–205.
Brose MS, Nutting CM, Jarzab B, Elisei R, Siena S, Bastholt L, et al. Sorafenib in radioactive iodine-refractory, locally advanced or metastatic differentiated thyroid cancer: a randomised, double-blind, phase 3 trial. Lancet. 2014;384:319–28. https://doi.org/10.1016/S0140-6736(14)60421-9.
Benekli M, Yalcin S, Ozkan M, Elkiran ET, Sevinc A, Cabuk D, et al. Efficacy of sorafenib in advanced differentiated and medullary thyroid cancer: experience in a Turkish population. Onco Targets Ther. 2014;15:1–5. https://doi.org/10.2147/OTT.S70670.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Özcan, Z., Yararbaş, Ü. (2019). Targeted Systemic Therapy May Be Promising in Radioiodine-Refractory Differentiated Thyroid Cancer. In: Özülker, T., Adaş, M., Günay, S. (eds) Thyroid and Parathyroid Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-78476-2_53
Download citation
DOI: https://doi.org/10.1007/978-3-319-78476-2_53
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-78475-5
Online ISBN: 978-3-319-78476-2
eBook Packages: MedicineMedicine (R0)