[Successful TSH suppression therapy with triiodothyronine in a patient with pulmonary metastases from differentiated thyroid carcinoma in the absence of 131I uptake].
A 28-year-old woman was referred to us to undergo 131I therapy who had multiple pulmonary metastases from papillary thyroid carcinoma after total thyroidectomy. There was no increased accumulation of a tracer in the pulmonary metastatic foci on whole-body scanning using a 111 MBq diagnostic dose of 131I. However, the pulmonary metastases were gradually decreased in size, and then clearly reduced 8 months after the start of TSH suppression therapy, which was maintained by T3 instead of T4 to bring down the serum TSH level below 0.1 microU/ml. Reduction rates of the foci were 33-76% on chest X-ray. The reduction was confirmed and no new lesions were found on the serial CT scans. Serum thyroglobulin level was lowered 80 to 25 ng/ml by this suppression therapy and progression of disease was not observed under a 54 months' T3 treatment. Thus, TSH suppression therapy might improve survival of patients with differentiated thyroid cancer.
Kosuda
S
S
Department of Surgery, Irumagawa Hospital.
Arai
S
S
Hohshito
Y
Y
Tokumitsu
H
H
Kusano
S
S
Kadota
T
T
D000328:Adult; D002291:Carcinoma, Papillary / Q000188:drug therapy* / Q000556:secondary; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000556:secondary; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D013954:Thyroglobulin / Q000097:blood; D013964:Thyroid Neoplasms / Q000473:pathology*; D013972:Thyrotropin / Q000097:blood*; D014284:Triiodothyronine / Q000008:administration & dosage*
D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D014284:Triiodothyronine; D013972:Thyrotropin; D013954:Thyroglobulin