title: Gamma probe-guided resection of a lymph node metastasis with I-123 in papillary thyroid carcinoma.
abstract: The authors report the case of a 27-year-old woman with gamma probe-guided resection of a recurrent regional lymph node metastasis in papillary thyroid cancer. Reoperation is often impaired in cases with extensive scarring because of previous surgery, high-dose radioiodine therapy, and external irradiation. In this case with nodal metastasis, the high I-123 uptake allowed more rapid intraoperative detection and influenced the surgical approach. Evidence of complete removal of tumor tissue could be given intraoperatively by measuring the tumor bed, and this was confirmed by postoperative normalization of Tg levels and a negative I-131 scan. In other locations, and especially for small solitary lesions, gamma probe-guided surgery may be a promising alternative to high dose I-131 therapy.
authors.affiliation: Department of Nuclear Medicine, Landeskrankenhaus, Klagenfurt, Austria.
authors.forename: H J
authors.initials: HJ
authors.lastname: Gallowitsch
authors.forename: J
authors.initials: J
authors.lastname: Fellinger
authors.forename: P
authors.initials: P
authors.lastname: Mikosch
authors.forename: E
authors.initials: E
authors.lastname: Kresnik
authors.forename: P
authors.initials: P
authors.lastname: Lind
mesh_terms: D000328:Adult; D002291:Carcinoma, Papillary / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D002921:Cicatrix / Q000473:pathology; D005260:Female; D015902:Gamma Cameras; D006801:Humans; D007430:Intraoperative Care; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000473:pathology*; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D010347:Patient Care Planning; D015642:Radiology, Interventional; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D011878:Radiotherapy / Q000009:adverse effects; D012086:Reoperation; D013954:Thyroglobulin / Q000097:blood; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D013965:Thyroidectomy / Q000009:adverse effects; D013972:Thyrotropin / Q000097:blood
chemical_list: D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D013972:Thyrotropin; D013954:Thyroglobulin