Haq M, Hyer S, Flux G, Cook G, Harmer C
Thyroid Unit, Royal Marsden Hospital, Surrey, London, UK.
Br J Radiol. 2007 Feb;80(950):e38-43. doi: 10.1259/bjr/52032397.
Thyrotoxicosis due to functioning metastases in differentiated thyroid cancer (DTC) is exceedingly rare. We report a case of follicular carcinoma in a 54-year-old manager, who presented with thyrotoxicosis, shortness of breath and lung metastases. Transbronchial biopsy of a pulmonary nodule demonstrated normal thyroid. This was interpreted as representing very well-differentiated thyroid cancer. CT, (131)I whole-body imaging and dosimetry is described following total thyroidectomy and repeated radioiodine administration (cumulative activity 34.6 GBq). The patient became asymptomatic with almost complete eradication of the pulmonary metastases. Potential complications of thyroid storm, bone marrow failure and pulmonary fibrosis following radioiodine are discussed, together with methods to minimise these risks.
分化型甲状腺癌（DTC）出现功能性转移导致甲状腺毒症极为罕见。我们报告一例54岁经理人的滤泡癌病例，该患者表现为甲状腺毒症、呼吸急促及肺转移。对一个肺结节进行经支气管活检显示为正常甲状腺组织。这被解释为代表高分化甲状腺癌。本文描述了全甲状腺切除术后及多次重复给予放射性碘（累积活度34.6GBq）后的CT、（131）I全身显像及剂量测定情况。患者症状消失，肺转移灶几乎完全消除。文中讨论了放射性碘治疗后甲状腺风暴、骨髓衰竭及肺纤维化等潜在并发症，以及将这些风险降至最低的方法。
