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CC BY-NC-ND 4.0 · World J Nucl Med 2020; 19(01): 61-64
DOI: 10.4103/wjnm.WJNM_29_19
Case Report

Failure of iodine uptake in microscopic pulmonary metastases after recombinant human thyroid-stimulating hormone stimulation

Courtney Lawhn-Heath
Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
,
Robert Flavell
Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
,
Eunice Chuang
1   Department of Medicine, Division of Endocrinology and Metabolism, University of California, San Francisco, CA, USA
,
Chienying Liu
2   Department of Endocrinology, Southern California Permanente Medical Group, Fontana, CA, USA
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Abstract

Elevated thyroid stimulating hormone (TSH) is required when preparing for radioactive iodine therapy in patients with differentiated thyroid cancer. Recombinant human TSH (rhTSH: Thyrogen; Genzyme Corporation, Cambridge, MA) avoids hypothyroidism and has been commonly used in place of thyroid hormone withdrawal (THW) in this process. We describe a 31-year-old woman with sclerosing variant of papillary thyroid cancer with multiple lymph node metastases and elevated postoperative thyroglobulin suggesting the presence of distant metastases, who was found to have miliary pulmonary metastases on the posttherapy I-131 scan after THW, but not visible on the post therapy scan after rhTSH preparation.

Keywords

Hypothyroidism - radioiodine - recombinant human thyroid-stimulating hormone - thyrogen - thyroid cancer

Financial support and sponsorship

Nil.




Publication History

Received: 05 April 2019

Accepted: 19 May 2019

Article published online:
19 April 2022

© 2020. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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