Elevated serum thyroglobulin levels at the time of ablative radioactive iodine therapy indicate a worse prognosis in thyroid cancer: an Australian retrospective cohort study

2016 ◽  
Vol 130 (S4) ◽  
pp. S50-S53 ◽  
Author(s):  
T J Matthews ◽  
E Chua ◽  
A Gargya ◽  
J Clark ◽  
K Gao ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Radioactive Iodine ◽  
Disease Free Survival ◽  
Disease Recurrence ◽  
Differentiated Thyroid Carcinoma ◽  
Radioactive Iodine Therapy ◽  
Serum Thyroglobulin ◽  
Free Survival ◽  
Thyroglobulin Level ◽  
Well Differentiated

AbstractBackground:Serum thyroglobulin is used as a surrogate marker for well-differentiated thyroid carcinoma recurrence. This study investigates whether thyroglobulin measured at the time of ablative radioactive iodine therapy predicts disease-free survival.Methods:A retrospective review was conducted of patients with well-differentiated thyroid carcinoma presenting from 1989 to 2010 at the Royal Prince Alfred Hospital, New South Wales, Australia. Disease-free survival of patients with a significantly elevated stimulated thyroglobulin level (27.5 µg/l or higher) at the time of ablative radioactive iodine therapy was compared to that of patients without a significantly elevated thyroglobulin level using univariate analysis.Results:Patients with a thyroglobulin level of 27.5 µg/l or higher had an increased relative risk of disease recurrence of 4.50 (95 per cent confidence interval = 1.35–15.04). If lateral neck dissection was required at the time of surgery, patients also had an increased relative risk of macroscopic disease recurrence of 4.94 (95 per cent confidence interval = 1.47–16.55).Conclusion:An elevated thyroglobulin level of 27.5 µg/l or higher at the time of ablative radioactive iodine therapy is a prognostic indicator for macroscopic disease recurrence in well-differentiated thyroid carcinoma.

scholarly journals Expression and Prognostic Value of α-, β-, andγ -Catenins in Differentiated Thyroid Carcinoma

2000 ◽  
Vol 85 (12) ◽  
pp. 4806-4811
Author(s):  
Jan Böhm ◽  
Leo Niskanen ◽  
Kari Kiraly ◽  
Jari Kellokoski ◽  
Matti Eskelinen ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Prognostic Value ◽  
Prognostic Significance ◽  
Differentiated Thyroid Carcinoma ◽  
Primary Treatment ◽  
Serum Thyroglobulin ◽  
Free Survival ◽  
Thyroglobulin Level ◽  
Traditional Risk Factors ◽  
Related Mortality

Catenins (α, β, and γ) are a group of intracellular cell adhesion molecules that unite cytoskeleton with extracellular adhesion system. Abnormal expression of these molecules may have prognostic relevance in various carcinomas, including differentiated thyroid carcinoma (DTC). We have, therefore, evaluated the prognostic value of α-, β-, andγ -catenins along with traditional risk factors in 206 consecutive DTC patients by immunohistochemistry. Papillary carcinomas showed normal staining pattern for α-, β-, andγ -catenins in 124 (60%), 136 (67%), and 94 (46%) cases, respectively. Follicular carcinomas expressed α-, β-, andγ -catenins normally in 16 (48%), 18 (55%), and 8 (32%) cases, respectively. Follicular type of tumor showed more often reduced staining for all catenins than papillary carcinoma (P = 0.009, P = 0.004, and P = 0.002, respectively). Age (>60 yr) and pTNM-stage were related to reduced α- and β-catenin expression levels (P = 0.027 and P = 0.026, respectively) and larger size of the tumor to reduced β- andγ -catenin expressions (P = 0.039 and P = 0.007, respectively). Nodal metastases at the time of primary treatment related to reduced α-catenin expression and distal metastases to reduced β- and γ-catenin staining signals (P = 0.022, P = 0.014, and P = 0.039, respectively). Reduced α-catenin associated with tumor recurrence (P = 0.002) and reduced β-catenin with cancer-related mortality (P = 0.005). The multivariate analysis for recurrence-free survival showed that α-catenin and serum thyroglobulin level 1 yr after primary treatment were prognostic of recurrent disease (hazards ratio, 3.42, P = 0.022; and hazards ratio, 10.03, P = 0.0001). In addition,α -catenin retained its prognostic significance in low-stage patients (P = 0.0151). We propose that the evaluation ofα -catenin expression by immunohistochemistry in DTC patients has prognostic value in addition to that obtained by traditional prognostic factors.

scholarly journals SUN-483 A Retrospective Diagnosis of Malignant Struma Ovarii After Discovery of Pulmonary Metastases

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Maham Qureshi ◽  
Preeti Kishore ◽  
Laura Boucai
Keyword(s):  
Thyroid Carcinoma ◽  
Radioactive Iodine ◽  
Pulmonary Metastases ◽  
Pulmonary Nodules ◽  
Differentiated Thyroid Carcinoma ◽  
Struma Ovarii ◽  
Papillary Thyroid ◽  
Malignant Struma Ovarii ◽  
Thyroglobulin Level ◽  
Well Differentiated

Abstract Background: Malignant struma ovarii is a rare ovarian tumor that is histologically identical to differentiated thyroid carcinoma.1 We present a case of a struma ovarii that was recognized as being malignant only after the discovery of pulmonary metastases. Clinical Case: A 29 year old female presented to the hospital with acute right lower abdominal pain, suspicious for ovarian torsion. She underwent urgent right salpingoopherectomy and pathology demonstrated a mature cystic teratoma with benign struma ovarii. Two years later, a CT of the abdomen incidentally revealed bilateral pulmonary nodules. Review of the imaging showed that these pulmonary nodules were also present two years prior, and had since become larger. Video-assisted thoracoscopic surgery was performed and lung biopsy was positive for well-differentiated thyroid carcinoma. The patient then underwent total thyroidectomy which revealed a 0.3 x 0.3 cm infiltrative papillary thyroid cancer, follicular variant, without lymphovascular invasion. Thyroglobulin level decreased from 169 ng/mL pre-operatively to 80 ng/mL post-operatively, but then continued to be variable ranging from 56 to 252 ng/mL (1.6-50 ng/mL). Thyroglobulin antibodies remained negative. Pathology from right ovary was re-reviewed at a second institution and found to be consistent with highly differentiated thyroid carcinoma with characteristic nuclear features of papillary thyroid carcinoma. A diagnostic whole body I-131 scan showed uptake within the thyroid bed, bilateral lung nodules, left distal thigh and right mid thigh. These thigh lesions were not visualized on lower extremity ultrasound. After dosimetry was performed, the patient received radioactive iodine-131 200 mCI. Post-therapy scan six days later demonstrated uptake in the thyroid bed, bilateral lungs and bilateral thighs. About five months later, thyroglobulin level had decreased to 0.4 ng/mL with a suppressed TSH. A repeat CT chest demonstrated that the lung nodules had all decreased in size, largest from 0.5 cm to 0.3 cm. Conclusion: Careful examination of struma ovarii pathology should be performed to evaluate for malignant features since benign appearing histology can present diagnostic difficulty.2 In this case, thyroglobulin level was lower than reported in previous cases; however, sites of metastases were responsive to radioactive iodine therapy indicating well differentiated disease and a favorable prognosis. References: 1. Goffredo P, Sawka AM, Pura J, Adam MA, Roman SA, Sosa JA. Malignant Struma Ovarii: A Population-Level Analysis of a Large Series of 68 Patients. Thyroid. 2015:25(2): 211-216. 2. Roth LM, Miller AW, Talerman A. Typical Thyroid-Type Carcinoma Arising in Struma Ovarii: A Report of 4 Cases and Review of Literature. Int J Gynecol Pathol. 2008:27(4): 496-506.

131J-speichernde pulmonale und ossäre Metastasen differenzierter Schilddrüsenkarzinome bei niedrigem Serum-Thyreoglobulinspiegel – Ausnahme in der Tumornachsorge?

1987 ◽  
Vol 26 (03) ◽  
pp. 139-142 ◽  
Author(s):  
G. Arning ◽  
O. Schober ◽  
H. Hundeshagen ◽  
Ch. Ehrenheim
Keyword(s):  
Serum Level ◽  
Thyroid Carcinoma ◽  
Bone Metastases ◽  
Differentiated Thyroid Carcinoma ◽  
Serum Thyroglobulin ◽  
Thyroglobulin Level ◽  
Low Serum

In the follow-up of differentiated thyroid carcinoma it is discussed whether the tumormarker thyroglobulin can replace the1311 scan, especially when the thyroglobulin serum level is normal. A positive1311 scan of metastases in the follow-up of patients with differentiated thyroid carcinoma combined with a low serum thyroglobulin level is extremely rare. The literature shows a frequency of about 4%. Recently we found 3 cases with a positive1311 scan demonstrating pulmonary and bone metastases whereas the serum thyroglobulin level was low.

scholarly journals Focal Bronchiectasis Causing Abnormal Pulmonary Radioiodine Uptake in a Patient with Well-Differentiated Papillary Thyroid Carcinoma

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Ash Gargya ◽  
Elizabeth Chua
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Radioactive Iodine ◽  
Differentiated Thyroid Carcinoma ◽  
Whole Body ◽  
Iodine Uptake ◽  
Papillary Thyroid ◽  
Radioiodine Uptake ◽  
Well Differentiated ◽  
Radioactive Iodine Uptake

Background. False-positive pulmonary radioactive iodine uptake in the followup of differentiated thyroid carcinoma has been reported in patients with certain respiratory conditions.Patient Findings. We describe a case of well-differentiated papillary thyroid carcinoma treated by total thyroidectomy and radioiodine ablation therapy. Postablation radioiodine whole body scan and subsequent diagnostic radioiodine whole body scans have shown persistent uptake in the left hemithorax despite an undetectable stimulated serum thyroglobulin in the absence of interfering thyroglobulin antibodies. Contrast-enhanced chest computed tomography has confirmed that the abnormal pulmonary radioiodine uptake correlates with focal bronchiectasis.Summary. Bronchiectasis can cause abnormal chest radioactive iodine uptake in the followup of differentiated thyroid carcinoma.Conclusions. Recognition of potential false-positive chest radioactive iodine uptake, simulating pulmonary metastases, is needed to avoid unnecessary exposure to further radiation from repeated therapeutic doses of radioactive iodine.

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