Oyen W J, Mudde A H, van den Broek W J, Corstens F H
Department of Nuclear Medicine, University Hospital Nijmegen, The Netherlands.
J Nucl Med. 1995 Apr;36(4):613-5.
Dedifferentiation of well-differentiated thyroid carcinoma is a well-known phenomenon that may lead to the disappearance of radioiodine uptake in tumors and the inability to treat patients with radioiodine. We report a patient in whom the 131I uptake progressively diminished to such low levels after a cumulative dose of 31.5 GBq that further 131I administration was considered nonbeneficial. Thereafter, metastases in the lungs and skeleton progressed. Because of the absence of any other therapeutic options, nearly 2 yr later we decided to reperform 131I measurements and scanning under hypothyroid conditions. All known metastatic lesions this time showed intense 131I uptake, more than 10-fold the previously measured values. High-dose 131I treatment was restarted.
高分化甲状腺癌的去分化是一种众所周知的现象，它可能导致肿瘤中放射性碘摄取消失，使患者无法接受放射性碘治疗。我们报告一名患者，在累积剂量达到31.5GBq后，其131I摄取逐渐减少至很低水平，进一步给予131I被认为无益处。此后，肺和骨骼转移灶进展。由于没有其他治疗选择，近2年后我们决定在甲状腺功能减退状态下重新进行131I测量和扫描。此次所有已知转移病灶均显示强烈的131I摄取，超过先前测量值的10倍以上。于是重新开始高剂量131I治疗。
