Treatment of radioiodine-negative bone metastasis from papillary thyroid carcinoma with percutaneous ethanol injection therapy
ABSTRACT A 62-year-old woman with metastatic papillary thyroid carcinoma in the sternum was successfully treated with percutaneous
ethanol injection therapy (PEIT) when previous radioiodine therapy and external irradiation were ineffective. The patient
tolerated the treatment well and the refractory pain in the anterior chest wall that was alleviated with morphine prior to
PEIT completely disappeared. No severe complications were observed. PEIT was performed 4 times (2 times with ultrasound guidance
and 2 times with CT guidance). The posttreatment CT scan and201T1 scintigraphy demonstrated significant decrease in the tumor volume. The serum thyroglobulin level fell to less than one-twentieth
of the pretreatment value. It is suggested that PEIT has a value in treating bone metastasis from thyroid carcinoma which
do not respond to radioiodine.
- SourceAvailable from: Kai Pun Wong
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- "Other options include percutaneous ethanol injection and radiofrequency ablation (RFA) as their efficacy have been shown in several studies   . The decision for further adjuvant RAI therapy after reoperative neck dissection depends on the completeness of the dissection . "
ABSTRACT: Although the majority of papillary thyroid carcinoma could be successfully managed by complete surgical resection alone or resection followed by radioiodine ablation, a small proportion of patients may develop radioiodine-refractory progressive disease which is not amenable to surgery, local ablative treatment or other treatment modalities. The use of FDG-PET/CT scan for persistent/recurrent disease has improved the accuracy of restaging as well as cancer prognostication. Given that patients with RAI-refractory disease tend to do significantly worse than those with radioiodine-avid or non-progressive disease, an increasing number of phase I and II studies have been conducted to evaluate the efficacy of new molecular targeted drugs such as the tyrosine kinase inhibitors and redifferentiation drugs. The overall response rate of these drugs ranged between 0-53%, depending on whether the patients had been previously treated with these drugs, performance status and extent of disease. However, drug toxicity remains a major concern in administration of target therapies. Nevertheless, there are also ongoing phase III studies evaluating the efficacy of these new drugs. The aim of the review was to summarize and discuss the results of these targeted drugs and redifferentiation agents for patients with progressive, radioiodine-refractory papillary thyroid carcinoma.12/2012; 2012:818204. DOI:10.1155/2012/818204
Chapter: Thyroid Gland[Show abstract] [Hide abstract]
ABSTRACT: Evaluation of the thyroid is required in a number of clinical situations (Freitas and Freitas 1994), i.e., clinically solitary thyroid nodule, superior mediastinal mass, hyperthyroidism, diagnosis and postoperative follow-up of thyroid carcinoma, neonatal hypothyroidism, and anomalous thyroid development.Radiological Imaging of Endocrine Diseases, 01/1999: pages 145-180;
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ABSTRACT: Treatment with isotretinoin (13-cis-retinoic acid, 13-cis-RA) is a recent additional option in advanced, otherwise intractable differentiated thyroid cancers. The aim of this study was to evaluate fluorine-18 fluorodeoxyglucose positron emission tomography (18F-FDG PET) in the prediction and the monitoring of response to 13-cis-RA therapy. Twenty-one patients with advanced differentiated thyroid cancers were investigated using 18F-FDG PET and iodine-131 whole-body scans before and 3, 6 and 9 months after initiation of 13-cis-RA therapy. After 9 months, 13-cis-RA treatment was discontinued and imaging procedures repeated 3 months later. Average 18F-FDG uptake (SUV) decreased significantly during 13-cis-RA therapy but subsequently increased in five of eight patients after withdrawal of 13-cis-RA. 18F-FDG uptake (SUV) 3 months after onset of 13-cis-RA therapy was significantly lower in patients who developed increased 131I uptake in their tumour sites than in patients with no subsequent increase in 131I uptake. There was no relationship between serum thyroglobulin level on the one hand and simultaneously measured 131I or 18F-FDG uptake on the other hand. There was a tendency towards lower 18F-FDG uptake in tumour manifestations with a better outcome. Therefore, 18F-FDG PET at 3 months after the start of treatment promises to differentiate between those patients who will eventually benefit from 13-cis-RA and those who will not. In conclusion, these data indicate that 18F-FDG PET is a useful tool for the evaluation and monitoring of adjuvant therapy with 13-cis-RA in thyroid cancer.European journal of nuclear medicine and molecular imaging 03/2002; 29(2):231-6. DOI:10.1007/s00259-001-0702-4 · 5.22 Impact Factor