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Recombinant Human Thyrotropin

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Thyroid Cancer

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Abstract

Initial management of patients with thyroid cancer often includes total thyroidectomy, long-term treatment with L-thyroxine often at doses sufficient for suppression of pituitary production of thyrotropin (TSH), and eradication of iodine-avid tissue (benign or malignant) with radioactive iodine in selected cases. Residual thyroid cancer will be present, or disease will recur, in ~ 15–20 % of patients, thereby leading to recommendations for long-term monitoring. In addition to careful interval patient history and physical examination, measurement of circulating levels of thyroglobulin and radiographic imaging are employed. Measurement of serum thyroglobulin, functional imaging with radioiodine, and structural imaging are used to monitor thyroid cancer patients. Of these, thyroglobulin measurement and radioiodine scans are relatively thyroid specific, providing high degrees of specificity. However, the sensitivities of iodine scanning and, in some cases, thyroglobulin measurement are limited by the small relative amount of thyroid tissue present in patients treated by thyroidectomy and dedifferentiation of tumor cells compared to normal thyrocytes. Therefore, radioiodine imaging and therapy require stimulation of thyroid tissue by elevated levels of TSH, and thyroglobulin measurement is also enhanced by TSH stimulation.

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  1. Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, Wexner Medical Center, The Ohio State University, 565 McCampbell Hall, 1581 Dodd Drive, Columbus, OH, 43210, USA

    Matthew D. Ringel MD

  2. Department of Medicine, University Hospitals, Case Western Reserve University, Chardon, OH, USA

    Stephen J. Burgun MD

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Correspondence to Matthew D. Ringel MD .

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  1. Department of Medicine, MedStar Washington Hospital Center Georgetown University School of Medicine, Washington, DC, USA

    Leonard Wartofsky

  2. Nuclear Medicine Research MedStar Research Institute and Washington Hospital Center, Georgetown University School of Medicine Washington Hospital Center, Washington, DC, USA

    Douglas Van Nostrand

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Ringel, M.D., Burgun, S.J. (2016). Recombinant Human Thyrotropin. In: Wartofsky, L., Van Nostrand, D. (eds) Thyroid Cancer. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-3314-3_10

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