AI Summary & Key Takeaways
AI InsightConclusion: Identification of pathological findings with WBS in patients who developed local recurrence in the absence of elevated Tg highlights the importance of diagnostic WBS in clinical follow-up.
📌 3 Key Takeaways
Abstract
Objective: Differentiated thyroid cancers (DTC) are tumors with good prognosis. However, local recurrence or distant metastasis can be observed. In our study, we aimed to investigate the incidence of recurrence and the importance of diagnostic iodine-131 whole body scan (WBS) in clinical follow-up in patients with DTC. Methods: The clinical data of 217 patients with DTC who were followed-up more than 3 years were reviewed retrospectively. The incidence of recurrence was investigated in a group of patients who had radioactive iodine (RAI) treatment and showed no sign of residual thyroid tissue or metastasis with diagnostic WBS that was performed at 6-12 months after therapy and had a thyroglobulin (Tg) level lower than 2 ng/dl. Results: At the time of diagnosis, ten cases had thyroid capsule invasion, 25 cases had extra-thyroid soft tissue invasion, 11 patients showed lymph node metastasis and four patients had distant organ metastasis. One hundred forty-five patients had RAI treatment at ablation dose (75-100 mCi), whereas 35 patients had RAI treatment at metastasis dose (150-200 mCi). Thirty-seven patients with papillary microcarcinoma did not receive RAI treatment. In 12 (%7.5) of the 160 patients who were considered as "successful ablation", a recurrence was identified. Recurrence was detected by diagnostic WBS in all cases and stimulated Tg level was <2 ng/dL with the exception of the two cases who had distant metastasis. Conclusion: Identification of pathological findings with WBS in patients who developed local recurrence in the absence of elevated Tg highlights the importance of diagnostic WBS in clinical follow-up.
Özet
Amaç: Diferansiye tiroit karsinomları (DTK) iyi prognoza sahip tümörlerdir. Ancak lokal rekürrens ve uzak metastaz izlenebilmektedir. Çalışmamızda DTK'lı olgularda rekürrens sıklığının ve tanısal iyot-131 (I-131) tüm vücut tarama sintigrafisinin klinik izlemdeki öneminin araştırılması amaçlandı.Yöntem: İzlem süresi 3 yılın üzerinde olan iki yüz on yedi DTK'lı olgunun klinik verileri retrospektif olarak incelendi. Radyoiyot (RAI) tedavisi alan hastalardan tedavi sonrası 6. ay-1. yıl tanısal I-131 tarama sintigrafisinde rezidüel tiroit dokusu ve metastaza ait bulgu saptanmayan, tiroglobulin (Tg) düzeyi 2 ng/dl'nin altında olan grupta rekürrens sıklığı araştırıldı. Bulgular: Tanı anında on olguda tiroit kapsülü, 25 olguda ekstratiroidal yumuşak doku invazyonu, 11 hastada lenf nodu metastazı ve dört hastada uzak metastaz mevcuttu. Yüz kırk beş olgu ablasyon dozunda (75-100 mCi), 35 olgu metastaz dozunda (150-200 mCi) RAI tedavisi almıştı. Papiller mikrokarsinom tanılı 37 hasta ise RAI tedavisi almamıştı. Tedavi başarısına karar verilen 160 hastanın 12'sinde rekürren hastalık saptandı (%7,5). Olguların tümünde rekürrens I-131 tarama sintigrafisi ile saptanmış olup uzak metastazı olan iki hasta dışında stimüle Tg değerleri <2 ng/dL idi. Sonuç: Lokal rekürrens gelişen tüm olgularda stimüle Tg yüksekliği olmaksızın I-131 tarama sintigrafisi ile patolojik bulguların saptanması klinik izlemde tanısal I-131 taramanın önemini vurgulamaktadır.