Disseminated Lung Metastases in Thyroid Cancer

A 23-year-old female suffered from a locally invasive well-differentiated thyroid papillary carcinoma with cervical lymph nodes metastases and disseminated lung metastases 16 years ago (in 1989). After undergoing a surgical operation, she had received subsequent accumulated therapeutic dose of 13 GBq (350 mCi) of 131I in the following two years. Thereafter, she delivered two healthy babies in 1993 and in1996, respectively. Ten years later (in 1999), persistent disseminated lung metastases were identified with a 7.4 GBq 131I post-therapy scan. Meanwhile, FDG-PET study was negative. In 2005, she received FDG-PET study, 131I therapy, and post-therapy 131I scan using the injection of recombinant human TSH instead of thyroxin withdrawal. The result showed nearly resolution of the metastatic lesions. The establishment of diagnostic/treatment guideline, the introduction of metabolic imaging modality, and the invention and production of recombinant human TSH in the past decade, this patient is able to receive accurate diagnosis, therapy and follow-up.