Endocrine Abstracts

Introduction: The incidence of thyroid cancers is increasing; they are considered to have a very good prognosis with good survival The frequency of metastases is 5 to 10%. The most common locations are lung and bone. The morbidity of metastatic disease is related to the initial histological type, tumour mass, location of metastases, age, possible loss of iodine uptake and 18F-FDG uptake

Materials and methods: We collected 25 patients treated for hormone-dependent differentiated thyroid carcinoma with pulmonary metastases. We first evaluated the therapeutic response to radioiodine according to histological factors; age and location of the metastasis Secondly, we evaluated the evolution of these patients: remission or evolutionary progression as well as the transition to a refractory form.

Results: In patients with pulmonary metastases: The predominant histological type is papillary in 76% The average age is 45 years Morphological evaluation reveals micronodular lesions in 53%; infra radiological in 20% and macro nodular in 28% of cases 68% of patients with pulmonary metastases are iodo avid metastases After univariate analysis, papillary histology is significantly more frequent in iodo avid lung metastases and aggressive forms are significantly more frequent in non iodo avid lung metastases Complete biological and morphological responses are significantly more frequent in iodo lung avid metastases Progression to a refractory form is significantly more frequent in patients over 40 years old and in non iodo avid lung metastases

Conclusion: Our results are in agreement with the data of the literature in fact the patients of less than 40 years: having a more frequent infra radiological forms are better responders to the radioactive iodine and a contrario the refractory forms are more frequent in the patients of more than 40 years