Thymic uptake after high-dose I-131 treatment in patients with differentiated thyroid carcinoma: a brief review of possible causes and management
| Autor: | Tomás Martín Hernández, María de la Cinta Calvo Morón, Manrique Borbón Arce, Juan Castro Montaño, Cristina Hernández Herrero, Teresa Cambil Molina, Pablo Antonio De la Riva Pérez |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
medicine.medical_specialty Endocrinology Diabetes and Metabolism medicine.medical_treatment Thymus Gland Thyroglobulin True Thymic Hyperplasia Metastasis Thyroid carcinoma Iodine Radioisotopes Young Adult Endocrinology Therapeutic index Adenocarcinoma Follicular medicine Humans Whole Body Imaging Thyroid Neoplasms Tomography Emission-Computed Single-Photon business.industry Neck dissection medicine.disease Thymectomy Surgery Thymic Tissue Lymphatic Metastasis Neck Dissection Female Radiology Thymus Hyperplasia Radiopharmaceuticals business |
| Zdroj: | Endocrinologia y nutricion : organo de la Sociedad Espanola de Endocrinologia y Nutricion. 62(1) |
| ISSN: | 1579-2021 |
| Popis: | Purpose To report five cases of patients diagnosed with differentiated thyroid carcinoma (DTC) with uptake in the thymic area after high-dose treatment with I-131 and to evaluate the potential causes and therapeutic management. Methods Five cases of young female patients with a mean age of 36.6 years (24–43) who had been treated with a mean dose of 106 mCi of I-131 (100–150 mCi) showing tracer uptake in the thymic area are reported. An I-131 whole-body scan (131I-WBS) was performed 7 days after therapeutic dose administration to each patient. Anterior and posterior planar images, followed by SPECT/CT of the head, neck and superior mediastinum were acquired in all patients. Thyroglobulin levels were measured with and without hormone replacement therapy in all cases. Samples taken from the superior mediastinum were sent to pathology for analysis, which confirmed the presence of thymic tissue. Results Two patients underwent elective total thymectomy due to the gross characteristics of the gland, local 131-I uptake, and high thyroglobulin levels. The remaining three patients had already undergone thymectomy as part of neck dissection during initial surgery, and no further invasive interventions were therefore performed. Pathological examination revealed no metastases in these five patients. Conclusions Thymus visualization in young patients after administration of therapeutic doses of I-131 seems to be a more common finding than usually thought. Absence of metastasis in the thymus despite high thyroglobulin levels was confirmed in all cases. Based on these results, we suggest that a more expectant and less aggressive therapeutic approach could be used. We also suggest that I-131 therapy for DTC should be considered in classification of the potential causes of true thymic hyperplasia in the subgroup of patients recovering from a stressor. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|