Session: SUN 459-496-Thyroid Neoplasia & Case Reports
Poster Board SUN-484
Clinical Case: A 47-year women without past history, showed painless mass in the anterior neck, 4 years ago. Denied symptoms of hypo/hyperthyroidism and neck radiation. No family history of thyroid malignancy. Physical examination: visible goiter, painless, multinodular, predominantly in the right lobe. TSH: 2.02 uIU/mL. Thyroid ultrasound: right thyroid nodule (5 x 4 x 4 cm). Fine needle aspiration biopsy: suspicious of Follicular Neoplasm in the right lower thyroid lobe. NIH Pathology report after Total Thyroidecty: Papillary Carcinoma of Thyroid poorly differentiated, predominant follicular variant; with areas of insular and solid differentiation at right lobe 5 cm limited to Thyroid gland. Areas of capsular infiltration are present. No lymphatic or vascular invasions. Hashimoto’s thyroiditis. Pathological staging: T3 NxMx. Anti-Thyroglobulin levels: 8.92 IU/ml. Thyroglobulin levels: 8.11. TSH: 3.370 uIU/ml. Patient was treated with radioiodine ablation therapy.
Conclusion: to our knowledge, there are not established treatments for PDTC-TIS. The impact of radioiodine treatment on the prognosis of patients with TIS carcinoma is not well known. In a previous study, many patients showed higher iodine uptake that were treated shortly after surgery compared with the uptake in patients who were treated at the time of local recurrence or distant spread. This was not the experience of other authors, who reported poor iodine uptake in a variable percentage of patients. In view the above evidences, in our patient, as the vast majority of patients, a homogeneous therapeutic approach were adopted, including total thyroidectomy and radioiodine therapy. We used the same dosage and timing as patients with well differentiated carcinoma who had disease of a similar stage and with similar clinical features. We recommended establishing the most helpful scoring system to define TIS carcinoma that carry a higher risk of aggressive behavior and also the impact of radioiodine treatment on the prognosis of patients with PDTC-TIS.
Nothing to Disclose: CP, JHM, OT, FS, EG, MDLMM
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