Mouaden A, Guerrouj H, Ghfir I, Aouad N Ben Rais
Nuclear Medicine Department, Ibn Sina Teaching Hospital, FMPR, Mohammed V University, Rabat, Morocco.
World J Nucl Med. 2023 Dec 26;22(4):300-305. doi: 10.1055/s-0043-1777692. eCollection 2023 Dec.
Differentiated thyroid cancer (DTC) is the most common endocrine cancer and its outcome is usually favorable. Its basic treatment is well codified, but its monitoring is much less. The value of thyroglobulin (Tg) is one of the main elements for monitoring DTC, while the use of iodine scintigraphy is becoming less recommended. In this case report, we discuss a clinical situation where a patient presented differentiated thyroid metastatic lesions confirmed by biopsy, uptaking radioactive iodine, with undetectable levels of Tg (in the absence of autoantibodies). We discuss the various hypotheses explaining this clinical situation, the potential advantages of performing periodic iodine scintigraphy in some intermediate and high-risk patients and report the documented clinical benefit of radioiodine therapy.
分化型甲状腺癌(DTC)是最常见的内分泌癌,其预后通常良好。其基本治疗方法已得到很好的规范,但监测方面则要少得多。甲状腺球蛋白(Tg)的值是监测DTC的主要指标之一,而碘闪烁扫描的使用则越来越不被推荐。在本病例报告中,我们讨论了一种临床情况,即一名患者经活检证实存在分化型甲状腺转移灶,摄取放射性碘,但Tg水平检测不到(在无自身抗体的情况下)。我们讨论了解释这种临床情况的各种假设、在一些中高危患者中进行定期碘闪烁扫描的潜在优势,并报告了放射性碘治疗已记录的临床益处。