Thyroid Cancer Clinical Trial
Official title:
Radioiodine-avid Bone Metastases From Differentiated Thyroid Cancer Without Structural Abnormality, a Singular Entity With Heterogeneous Outcomes.
Bone radioiodine (RAI) uptake without structural abnormality in thyroid cancer (TC) patients
may be related to false positive or to microscopic foci of metastatic tissue. In such cases,
outcome is reported to be excellent.
Indeed, Robenshtok et al. reported a serie of patients with RAI-avid bone metastases of TC
without structural abnormality on imaging studies who have more favorable long-term prognosis
than those harbouring structurally visible bone metastases and do not undergo
skeletal-related complications.
The investigators report the case of Mrs D., who had been operated for a pathologic tumor
stage 3: pT3(m) poorly differentiated TC at the age of 43. The first post-therapeutic whole
body scan revealed 3 foci of bone uptake (right clavicle, L2, L3). The elevated level of
thyroglobulin (157ng/mL) favoured the hypothesis of bone metastases despite the absence of
any structural lesion on CT and MRI. She received 7 courses of radioiodine therapy. The right
clavicle RAI uptake persisted, and subsequent CT disclosed an osteolytic lesion which was
treated by radiofrequency and external beam radiation. Twenty-five years after the diagnosis,
she has a persistent morphological disease with a 30x8mm progressive lesion on the right
clavicle, for which surgery is planned.
The aim of the present study is to describe the natural history and evolution of radioiodine
avid bone metastases from thyroid cancer without structural abnormalities and to identify
prognosis factors.
n/a
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