CQ43. What Is the Benefit of RAI Therapy for Local Recurrence, Lymph Node Metastasis and Distant Metastasis of Differentiated Thyroid Carcinoma?

2012 ◽  
pp. 239-241
Author(s):  
Seigo Kinuya ◽  
Naoyuki Shigematsu ◽  
Yasushi Noguchi ◽  
Tatsuya Higashi
1970 ◽  
Vol 15 (2) ◽  
pp. 60-68
Author(s):  
Nanda Kishore Sinha ◽  
Md Monjurul Alam ◽  
Dewan Golam Md Akaiduzzaman ◽  
M Alauddin

Total 60 patients were selected as per described criteria from the department of Otolaryngology and head neck surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from January 2005 to October 2006. In this study of 60 patients of differentiated thyroid carcinoma (DTC), majority of the patients are within 31-50 yrs age group with female predominance. Papillary carcinoma was more common in 31-40 yrs age group and follicular carcinoma was more common in 41-50 years. Thyroid swelling was the most common presenting symptom of DTC (91.66%), followed by cervical lymphadenopathy (33.33%). Among the 60 DTC patients, papillary carcinoma was commoner (73.33%) than follicular carcinoma (26.67%). Overall female-male ratio for these 60 patients of DTC was 1.72: 1, but in papillary type the ratio was 1.44:1. and for follicular carcinoma was 3:1. Out of 44 papillary carcinoma patients 18 patients had cervical lymph node metastasis (40.90%), and out of 16 follicular carcinoma patients 2 had cervical lymph node metastasis (12.50%); P < 0.05. Among the 44 papillary carcinoma patients only 1 had distant metastasis (2.27%), and among the 16 follicular carcinoma patients 4 had distant metastasis (25%); P <0.05. 85% of the patients were presented with unilateral and 15% were presented with bilateral lymph node metastasis. In this series, distant metastasis was found in bone and lung, Maximum lymph node metastasis was found in level II (42.10%), level III (57.89%) and level IV (42.10%). Finally the Chi-square (x2) significance test was performed according to above described findings and it was found that there is significant difference in the pattern of lymph node metastasis and of distant metastasis between papillary and follicular type of DTC (P<0.05). Key words: Thyroid carcinoma; Metastasis. DOI: 10.3329/bjo.v15i2.5059 Bangladesh J Otorhinolaryngol 2009; 15(2): 60-68


Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 553
Author(s):  
Elizabeth de Koster ◽  
Taban Sulaiman ◽  
Jaap Hamming ◽  
Abbey Schepers ◽  
Marieke Snel ◽  
...  

Changing insights regarding radioiodine (I-131) administration in differentiated thyroid carcinoma (DTC) stir up discussions on the utility of pre-ablation diagnostic scintigraphy (DxWBS). Our retrospective study qualitatively and semi-quantitatively assessed posttherapy I-131 whole-body scintigraphy (TxWBS) data for thyroid remnant size and metastasis. Findings were associated with initial treatment success after nine months, as well as clinical, histopathological, and surgical parameters. Possible management changes were addressed. A thyroid remnant was reported in 89 of 97 (92%) patients, suspicion of lymph node metastasis in 26 (27%) and distant metastasis in 6 (6%). Surgery with oncological intent and surgery by two dedicated thyroid surgeons were independently associated with a smaller remnant. Surgery at a community hospital, aggressive tumor histopathology, histopathological lymph node metastasis (pN1) and suspicion of new lymph node metastasis on TxWBS were independently associated with an unsuccessful treatment. Thyroid remnant size was unrelated to treatment success. All 13 pN1 patients with suspected in situ lymph node metastases on TxWBS had an unsuccessful treatment, opposite 19/31 (61%) pN1 patients without (p = 0.009). Pre-ablative knowledge of these TxWBS findings had likely influenced management in 48 (50%) patients. Additional pre-ablative diagnostics could optimize patient-tailored I-131 administration. DxWBS should be considered, especially in patients with pN1 stage or suspected in situ lymph node metastasis. Dependent on local surgical expertise, DxWBS is not recommended to evaluate thyroid remnant size.


Author(s):  
Wan Mohd Nazlee Wan Zainon ◽  
Wan Faiziah Wan Abdul Rahman ◽  
Maya Mazuwin Yahya ◽  
Nor Azwani Mat Nawi ◽  
Nurul Shamimi Suhaimi ◽  
...  

Abstract Background In cases of papillary thyroid carcinoma (PTC), lymph nodes are a typical site of metastasis. Extrathyroidal tissue involvement in differentiated thyroid carcinoma causes the disease to progress and affects the patients’ treatment options. Papillary thyroid carcinoma (PTC) is the common type in differentiated thyroid carcinoma (DTC), the other type is follicular thyroid carcinoma (FTC). Ectopic sites, such as intrathyroidal lymph node invasion in classical papillary thyroid malignancy, are extremely uncommon. It can be difficult to detect an intrathyroidal lymph node (ITLN) during a histopathological test, but it is important to do so since it affects the stage of the disease and subsequent treatment. Case presentation We present the case of a 63-year-old woman who presented with multinodular goitre and underwent total thyroidectomy. She was diagnosed with aberrant intrathyroidal lymph node metastases during pathological testing, resulting in an upgrade in treatment. Owing to the exceptionally unusual ectopic position of lymph node metastasis, in this case, there is a risk of diagnostic and therapeutic misinterpretation. This patient was treated with high-dose radioactive iodine in view of lymph node metastases. Conclusions Identification of ITLN by imaging characteristics is sometimes difficult, being often an intraoperative discovery and histopathological correlation that lead to upstage the disease and alter the final management.


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