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A Case-Based Guide to Clinical EndocrinologyMetastatic Papillary Thyroid Cancer

A Case-Based Guide to Clinical Endocrinology: Metastatic Papillary Thyroid Cancer Chapter 12 Henry B. Burch Objectives 1. To understand the diagnosis and staging of differentiated thyroid cancer 2. To become familiar with unusual presentations of papillary thyroid cancer 3. To recognize challenges associated with the management of thyroid cancer with distant metastases 4. To review the indications and methodology of thyrogen-stimulated radioiodine therapy 5. To review the management of iodine excess in a patient awaiting radioiodine therapy Case Presentation A 59-year-old man with a history of toxic multinodular goiter presents to his pri- mary care physician with progressive low back pain. A magnetic resonance imaging (MRI) scan of the spine reveals a 4.0-cm left paraspinal mass with nearly complete obliteration of the L3 vertebral body. A computed tomography (CT)-guided biopsy shows the lesion, a metastatic papillary thyroid cancer, and serum thyroglobulin levels are greater than 2100 ng/mL. The patient’s past medical history is significant for type 1 diabetes mellitus complicated by advanced retinopathy and peripheral vascular disease as well as chronic renal failure. Five years earlier he underwent combined kidney and pancreatic transplantation and has remained insulin-free and off dialysis ever since. His toxic multinodular goiter was treated 6 years earlier with radioiodine therapy, resulting in hypothyroidism. He also http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png

A Case-Based Guide to Clinical EndocrinologyMetastatic Papillary Thyroid Cancer

Part of the Contemporary Endocrinology™ Book Series
Editors: Davies, Terry F.
Burch, Henry B.
A Case-Based Guide to Clinical Endocrinology — Jan 1, 2008
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Publisher
Humana Press
Copyright
© Humana Press,Totowa, NJ 2008
ISBN
978-1-58829-815-7
Pages
121 –126
DOI
10.1007/978-1-60327-103-5_12
Publisher site
See Chapter on Publisher Site

Abstract

Chapter 12 Henry B. Burch Objectives 1. To understand the diagnosis and staging of differentiated thyroid cancer 2. To become familiar with unusual presentations of papillary thyroid cancer 3. To recognize challenges associated with the management of thyroid cancer with distant metastases 4. To review the indications and methodology of thyrogen-stimulated radioiodine therapy 5. To review the management of iodine excess in a patient awaiting radioiodine therapy Case Presentation A 59-year-old man with a history of toxic multinodular goiter presents to his pri- mary care physician with progressive low back pain. A magnetic resonance imaging (MRI) scan of the spine reveals a 4.0-cm left paraspinal mass with nearly complete obliteration of the L3 vertebral body. A computed tomography (CT)-guided biopsy shows the lesion, a metastatic papillary thyroid cancer, and serum thyroglobulin levels are greater than 2100 ng/mL. The patient’s past medical history is significant for type 1 diabetes mellitus complicated by advanced retinopathy and peripheral vascular disease as well as chronic renal failure. Five years earlier he underwent combined kidney and pancreatic transplantation and has remained insulin-free and off dialysis ever since. His toxic multinodular goiter was treated 6 years earlier with radioiodine therapy, resulting in hypothyroidism. He also

Published: Jan 1, 2008

Keywords: Thyroid Cancer; Bone Metastasis; Papillary Thyroid Cancer; Differentiate Thyroid Cancer; Radioiodine Therapy

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