Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Pathology Department, Ghaem hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
BMC Endocr Disord. 2021 Nov 4;21(1):221. doi: 10.1186/s12902-021-00883-7.
The term non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) was recently proposed as a non-malignant thyroid lesion with indolent behavior that does not require post-operative radio-iodine treatment. We are reporting a case of NIFTP with bone metastasis that is the second case reported so far.
We describe a 38-year-old woman who presented with an indeterminate thyroid nodule and underwent total thyroidectomy with the finding of NIFTP on careful pathologic examination. However, her initial follow-up evaluation revealed a serum thyroglobulin level of > 300 ng/ml and a diagnostic whole body I scan demonstrated a focus of increased uptake in the left hemipelvis, confirmed on CT scan to be a lytic lesion in the left iliac bone. She was treated with 7.4GBq (200 mCi) of I and her follow-up 1 year later revealed an undetectable serum thyroglobulin and a negative whole body I scan with no visible uptake in the iliac bone indicating an excellent response.
This case presentation reminds us to be alert to the rare occurrence of distant metastasis in NIFTP and the need for a case by case analysis and continuing post-operative follow-up for detection of residual or recurrent disease.
最近提出了术语“具有乳头状核特征的非侵袭性滤泡性甲状腺肿瘤（NIFTP）”，它是一种具有惰性行为的非恶性甲状腺病变，不需要术后放射性碘治疗。我们报告了一例伴有骨转移的 NIFTP，这是迄今为止第二例报道。
我们描述了一名 38 岁女性，因不确定的甲状腺结节就诊，行甲状腺全切除术，仔细的病理检查发现为 NIFTP。然而，她的初始随访评估显示血清甲状腺球蛋白水平>300ng/ml，诊断性全身碘扫描显示左半骨盆有一处摄取增加的焦点，CT 扫描证实为左侧髂骨的溶骨性病变。她接受了 7.4GBq（200mCi）的碘治疗，一年后的随访显示血清甲状腺球蛋白无法检测到，全身碘扫描未见髂骨摄取，表明治疗效果极好。
本病例提醒我们要警惕 NIFTP 中罕见的远处转移，并需要对每例患者进行分析，并继续术后随访，以检测残留或复发性疾病。
