Malhotra Gaurav, Nair Narendra, Menon Hari, Gujral Sumit, Abhyankar Amit, Baghel Nawab S, Awasare Sushama, Nabar Swapna J, Abhyankar Suman, Kand Purushottam G
Radiation Medicine Centre, Bhabha Atomic Research Centre, TMC Annexe, Tata Memorial Hospital, Parel, Mumbai.
Clin Nucl Med. 2008 Jan;33(1):26-9. doi: 10.1097/RLU.0b013e31815c50a8.
A 52-year-old man with follicular thyroid carcinoma was administered 182 mCi of radioiodine (I-131) a month after total thyroidectomy. Post-therapy scan revealed diffuse uptake of radioiodine in the apical left lung. CT-guided biopsy of this mass revealed mucinous bronchoalveolar carcinoma. Immunohistochemistry for thyroglobulin was negative. An FDG PET scan showed avid uptake in the lung mass. Surgery was ruled out, so he was given chemotherapy, without benefit. The lesion continued to show I-131 uptake even while on daily T3 substitution, suggesting that the mass was thyroid stimulating hormone-independent. Because the mass showed I-131 uptake and chemotherapy was not beneficial, it was decided to treat with I-131. He was continued on T3 substitution therapy and was given 209 mCi of I-131. Follow-up CT scan a few weeks later reported a 1-cm all round reduction of the mass. I-131 scan showed avid tracer uptake in the mass. This case suggests the possibility of this therapeutic option in nonthyroidal tumors that may concentrate radioiodine.
一名52岁的滤泡性甲状腺癌男性患者在全甲状腺切除术后一个月接受了182毫居里的放射性碘（I-131）治疗。治疗后扫描显示左肺尖部有放射性碘的弥漫性摄取。对该肿块进行CT引导下活检，结果显示为黏液性细支气管肺泡癌。甲状腺球蛋白免疫组化检查为阴性。FDG PET扫描显示肺部肿块有明显摄取。由于排除了手术可能性，因此给他进行了化疗，但未见疗效。即使在每日服用T3替代治疗期间，该病灶仍持续显示有I-131摄取，提示该肿块不依赖促甲状腺激素。鉴于该肿块显示有I-131摄取且化疗无效，决定采用I-131治疗。继续给予他T3替代治疗，并给予209毫居里的I-131。几周后的随访CT扫描报告肿块整体缩小了1厘米。I-131扫描显示肿块有明显的示踪剂摄取。该病例提示了这种治疗选择在可能浓聚放射性碘的非甲状腺肿瘤中的可能性。
