Use of recombinant human thyrotropin in a complicated case of metastatic papillary thyroid carcinoma.
OBJECTIVE
To describe a complicated case of metastatic papillary thyroid carcinoma and the use of recombinant human thyrotropin (thyroid-stimulating hormone) (rhTSH) in conjunction with treatment with radioactive iodine (131I).


METHODS
We present a detailed case report and discuss the use of rhTSH in this setting.


RESULTS
A 62-year-old Filipino man with a history of incompletely treated papillary thyroid cancer sought medical assistance in the emergency department because of weakness of the right upper extremity. Imaging studies showed a large mediastinal mass in association with C7 vertebral body erosion and spinal cord impingement. A cervical lymph node biopsy revealed papillary thyroid carcinoma, follicular variant. Further imaging studies disclosed widely metastatic disease. The patient subsequently had a complicated treatment course and received rhTSH in conjunction with 131I treatment.


CONCLUSIONS
This unusual case demonstrates possible complications of metastatic papillary thyroid carcinoma along with innovations in treatment options, including the use of rhTSH to stimulate the uptake of radioiodine by thyroid cancer cells.
Aslam
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SN
Department of Internal Medicine, Section of Endocrinology and Metabolism, Naval Medical Center, San Diego, California 92134-3300, USA.
Daly
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RG
D001706:Biopsy; D002291:Carcinoma, Papillary / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D003131:Combined Modality Therapy; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008479:Mediastinal Neoplasms / Q000556:secondary; D008875:Middle Aged; D018908:Muscle Weakness / Q000150:complications; D011994:Recombinant Proteins / Q000627:therapeutic use; D013120:Spinal Cord Neoplasms / Q000556:secondary; D013954:Thyroglobulin / Q000378:metabolism; D013964:Thyroid Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D013972:Thyrotropin / Q000627:therapeutic use*
D011994:Recombinant Proteins; D013972:Thyrotropin; D013954:Thyroglobulin