RESUMO
A small abut important subset of patients with differentiated thyroid cancer will die of disease. Our approach to therapy treats almost all patients similarly, with aggressive surgery and I-131 therapy. Meticulous follow-up should include multiple I-131 diagnostic scans using at least 5 to 10 mCi of I-131 with attention to proper patient preparation and good quality procedures. Thyroglobulin levels should be monitored, and other radiographic diagnostic procedures, including thallium scans and MR imaging, should be used as needed. Until screening tests are discovered which will accurately pinpoint patients at high risk for aggressive, recurrent thyroid cancer, the best course of action appears to be aggressive management, including radioiodine therapy.
Assuntos
Radioisótopos do Iodo/uso terapêutico , Neoplasias da Glândula Tireoide/radioterapia , Feminino , Humanos , Radioisótopos do Iodo/efeitos adversos , Masculino , Metástase Neoplásica , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgiaRESUMO
We present a case of painful osseous sarcoid involving the tibiae bilaterally. Lesions were initially found on plain radiographs and on a 99mTc-MDP bone scan. The patient was also found to have CNS involvement of sarcoidosis in the form of diabetes insipidus and panhypopituitarism. CNS lesions were demonstrated on CT and MR images.
Assuntos
Doenças Ósseas/diagnóstico por imagem , Encefalopatias/diagnóstico por imagem , Sarcoidose/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Feminino , Humanos , Articulação do Joelho/diagnóstico por imagem , Pessoa de Meia-Idade , Cintilografia , Medronato de Tecnécio Tc 99m , Tomografia Computadorizada por Raios XRESUMO
Papillary thyroid carcinoma is a common thyroid malignancy that generally has a good prognosis. However, this type of cancer may give rise to distant metastasis and may behave more aggressively in older patients. Here we report clinical, radiological, and pathological findings of a patient with papillary thyroid carcinoma who had a solitary cerebellar metastasis. The patient was known to have metastatic thyroid cancer to the lungs, but this had been stable and the cerebellar metastasis presented an unanticipated significant problem. The rapid detection of cerebellar metastatic disease is critical because neurosurgical removal of the solitary lesion should be considered as the treatment of choice. This case also serves to remind us of the importance of considering possible metastatic brain lesions and their acute life-threatening complications in contrast to the relatively prolonged course associated with metastases of thyroid carcinoma to other organs.