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Results for “IODINE, RADIOACTIVE”

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Radioactive iodine treatment of metastatic thyroid carcinoma with clinical thyrotoxicosis.

We present a case of well-differentiated follicular carcinoma of the thyroid with hyperfunctioning metastases and clinical thyrotoxicosis. The recommended I-131 treatment dose for patients with widespread bone metastases from thyroid carcinoma is 200 mCi. However, in a patient with hyperfunctioning metastatic tumor and increased radioiodine uptake, the treatment dose should be modified. Radiation dosimetry measurements performed on the patient in this study demonstrated that 132 mCi would be a safe therapeutic I-131 dose which would avoid injury to normal radiosensitive tissues. Consequently, she was given a 130-mCi therapeutic dose.

Adenocarcinoma↗

Chronic myeloid leukemia in a man with papillary carcinoma of the thyroid treated with radioactive iodine.

Leukemia as a second malignancy after treatment of thyroid cancer is rare. Most cases reported in the literature have occurred after cumulative doses higher than 800 mCi and it is most commonly acute leukemias. We report a case of chronic myeloid leukemia (CML) occurring in a 40-year-old man 14 years after treatment of papillary thyroid carcinoma. Our patient had the longest interval between the diagnosis of CML and administration of 131I.

Adult↗

Nasolacrimal duct obstruction associated with radioactive iodine therapy for thyroid carcinoma.

A 50-year-old woman presented with a 5-year history of unilateral epiphora that began shortly after 131I therapy for thyroid carcinoma. A recent recombinant human thyroid-stimulating hormone (Thyrogen) scan had shown a focus of uptake adjacent to the right eye that was initially thought to be a possible metastasis. Probing and irrigation revealed complete blockage of the right nasolacrimal duct. The patient underwent a right dacryocystorhinostomy (DCR) and biopsy of the lacrimal sac. Histopathologic examination of the lacrimal sac and nasal mucosa revealed foreign-body reaction and fibrosis with no malignant cells. A repeat Thyrogen scan after DCR showed no residual focus of activity in the nose or near the lacrimal sac and confirmed reestablishment of lacrimal drainage on the right side. This case demonstrates that 131I therapy for thyroid carcinoma can be associated with nasolacrimal duct obstruction. The appearance of a focus of uptake near the lacrimal sac on Thyrogen scanning in a patient with a history of thyroid carcinoma may not be due to a new focus of metastasis and may indeed be due to pooling of 131I in the lacrimal sac due to nasolacrimal duct blockage.

Carcinoma, Papillary↗