ECE2017 Eposter Presentations: Thyroid Clinical case reports - Thyroid/Others (30 abstracts)
Follicular variant of papillary thyroid carcinoma with lung, bone, and soft tissue metastases
Constantinos Belis 1 , Stavroula Gavriilidou 1 , Aikaterini Afentoulidi 1 , Kalliopi Xydiari 1 , Vasilios Athanasiou 1 , Sofia Malaktari- Skarantavou 1 , Sofia Saranti 2 & Christos Savvidis 1
1Department of Endocrinology, ‘Hippocratio’ General Hospital of Athens, Athens, Greece; 2Nuclear Medicine Department, ‘Saints Anargyri’ Cancer Hospital, Athens, Greece.
We report on a case of a 63-year-old male patient with a history of metastatic DTC, with both lung and bone metastases and an additional paravertebral mass. The patient presented with enlargement of the left thyroid lobe. FNA was positive for malignancy and subsequent CTs were negative for distant metastases, whereas laboratory tests showed elevated thyroglobulin (Tg>500 ng/ml). The patient underwent total thyroidectomy and the pathology report revealed a multifocal, follicular variant of papillary thyroid cancer, with localized extrathyroidal extention. He was then referred to the Endocrinology Department. After withdrawal of levothyroxine (preablation laboratory results: TSH: 52.6 μIU/ml, Tg: 9900 ng/ml) the patient received 80 mCi of I131 (RAI uptake: 7,6%).. A subsequent SPECT/CT scan revealed lung and bone metastases (ribs with adjacent soft tissue mass). Thoracic CT showed bilateral, scattered lung metastases with lymph node enlargement of the hili as well as a paravertebral soft tissue mass 6.2×3.8 cm of diameter which metastasize to the 7th rib and the respective thoracic vertebra. Tc99m bone scan showed metastases in the ribs (6th, 7th) as well as the 7th thoracic vertebra. The patient 6 months later received 150 mCi I131. The post-therapeutic scan revealed radioiodine avid metastases in both lungs without response to the previous therapy as well as uptake in the right maxillary area. The latter blood test (6 months after the 2nd RAI) showed biochemical improvement (Tg: 403 ng/ml, anti-Tg <42 IU/ml), while the last thoracic CT (6 months after the 2nd RAI treatment) revealed radiologic improvement on the lung metastases and the paravertebral mass (5.6×3 cm), as well as disappearance of the right maxillary area lesion. The case presented is about the management of a patient with DTC and distant metastases, without objective benefit showed by the postablation scan, but followed by decreasing Tg and radiologic improvement revealed by computed tomography.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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