Follicular Thyroid Cancer and Bone Metastasis
A 78-year-old male patient with follicular carcinoma in the left thyroidal lobe with 10 cm diameter received radioiodine ablation treatment (RAT) with 5550 MBq (150 mCi) iodine-131 (131I) 2 months after the operation. During the RAT, the serum thyroglobulin (Tg) level was measured as 252.59 ng/ml. Radioiodine uptake in the thyroid bed and thoracal and pelvic regions was observed on a postablative whole-body scintigraphy. Simultaneous bone scintigraphy was performed. A moderately increased uptake was observed in the right iliac bone. Thoracal and pelvic computed tomographies (CTs) were also performed for further evaluation of the radioiodine uptake in thoracal and pelvic regions. A pathologic soft tissue lesion of 2.5 × 1.5 cm that may have been compatible with a lymphadenopathy on the anterior mediastinum was observed, and a sclerotic bone lesion of 2 cm in diameter that was concordant with metastasis on the right iliac bone was reported on CT. The patient was followed up for 5 years under suppressive dose of LT4 treatment. Serum Tg measurements and pelvic CT and/or MRI were performed periodically. Biochemical and radiological stabilization were detected during the 5-year follow-up period. Additional surgery or local therapy for the bone metastasis was not applied because of the asymptomatic and stable local metastatic disease.
KeywordsFollicular thyroid carcinoma Bone metastases Radioiodine
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