Holmquest D L, Lake P
J Nucl Med. 1976 Apr;17(4):307-9.
A patient with papillary--follicular carcinoma of the thyroid, with metastases to the lungs, skeleton, and brain was treated 5 weeks after thyroidectomy with 135 mCi of 131I. Although preliminary studies with 1 mCi had not shown any iodine uptake by the brain metastasis, this lesion showed intense concentration at the time of the larger therapeutic dose. Four days later, acute hemorrhage of the tumor occurred, requiring surgical removal. Although 131I therapy would seem an unlikely cause of acute necrosis and hemorrhage in these lesions, the association of therapeutic radioiodine and hemorrhage is interesting. Since recent reports suggest that brain metastasis may be somewhat more common than previously suspected, we suggest that brain imaging be included in the workup prior to radioiodine therapy of patients with advanced metastatic disease or neurologic symptoms.
一名患有甲状腺乳头滤泡状癌且已转移至肺、骨骼和脑部的患者，在甲状腺切除术后5周接受了135毫居里的131I治疗。尽管之前用1毫居里进行的初步研究未显示脑转移灶有任何碘摄取，但在给予较大治疗剂量时，该病灶出现了强烈浓聚。四天后，肿瘤发生急性出血，需要手术切除。虽然131I治疗似乎不太可能是这些病灶急性坏死和出血的原因，但治疗性放射性碘与出血之间的关联很有意思。由于最近的报告表明脑转移可能比之前怀疑的更为常见，我们建议在对晚期转移性疾病患者或有神经症状的患者进行放射性碘治疗之前，将脑部成像纳入检查流程。
