[Consequences of the persistence of large thyroid remnants after bilateral thyroidectomy for differentiated thyroid cancer].
Twenty-three patients submitted to thyroidectomy and before ablative therapy and with cervical uptake >10% were compared to 48 patients with uptake <2%. All but 3 patients with large remnants reached TSH levels >30 mIU/l after thyroxin withdrawal. Cervical pain requiring anti-inflammatory treatment after radioiodine was more frequent in patients with larger remnants (34.7% vs. 10.4%). Remnant ablation was successful in 56% of the individuals with uptake >10% and in 93.3% of those with uptake <2%. The sensitivity of diagnostic scanning for pulmonary metastases was similar (71.4% vs. 77.7%). The specificity of stimulated thyroglobulin at a cut-off of 5 ng/ml was 100% for patients with discrete remnants but only 37.5% for the others. We conclude that significant thyroid remnants (cervical uptake >10%) result in a lower efficacy of ablation, cause more local symptoms after radioiodine, and compromise the specificity of thyroglobulin measurements.
Rosário
Pedro Weslley S
PW
Departamento de Tireóide, Clínica de Endocrinologia e Metabologia, Serviço de Medicina Nuclear, Santa Casa de Belo Horizonte, Belo Horizonte, MG. cepcem.bhz@zaz.com.br
Cardoso
Ludmilla David
LD
Barroso
Alvaro
A
Padrão
Eduardo L
EL
Rezende
Leonardo
L
Purisch
Saulo
S
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods