The Prognostic Power of Preablation Stimulated Thyroglobulin in Children With Differentiated Thyroid Cancer.

OBJECTIVE: To analyze prognostic factors in children with differentiated thyroid carcinoma (DTC) who have been treated in a single center in the last 27 years. METHODS: We studied 126 children (≤18 years old) who have been treated with near-total thyroidectomy followed by radioiodine therapy and thyroid hormone replacement. Follow-up of the patients was done 2, 6, and 12 months after treatment and then by yearly evaluation. Response to treatment was defined according to the American Thyroid Association guidelines. RESULTS: Papillary thyroid cancer was the main pathology (93.7%), and 52.4% of the patients had lymph node metastasis at presentation, which was extensive (>5) in 30% of the patients. Distant metastasis was seen in 8.8%. The mean initial dose of I-131 was 74 ± 42.2 MBq/kg. The median follow-up was 59 months and the median time to achieve an excellent response was 29 months. The preablation stimulated thyroglobulin (psTg) level was 202.4 ± 301.8 ng/mL in patients with first-year incomplete response compared with 11.2 ± 17.5 ng/mL in others (P =.001). Furthermore, using logistic regression, the psTg level was found to be the only significant predictor of distant metastasis, and psTg ≥ 13.75 ng/mL was the most powerful predictor of first-year incomplete response. Moreover, distant metastasis was more common in boys than in girls, and it took longer time for boys to achieve an excellent response. CONCLUSION: The psTg level was the only significant predictor of distant metastases in children with DTC, and psTg ≥ 13.75 ng/mL was the most powerful predictor of first-year incomplete response.

Prostate Cancer With Neuroendocrine Differentiation Recurring After Treatment With 177Lu-PSMA: A Chance for 177Lu-DOTATATE Therapy?

ABSTRACT: Prostate cancer with NED (neuroendocrine differentiation) may occur in various stages of the disease, which is associated with a poor prognosis and treatment resistance. We present a case of a patient with metastatic castration-resistant prostatic cancer, who was treated with 7 cycles of 177Lu-PSMA and a very good response. Although only few foci with PSMA uptake were remained in the last posttreatment images, PSA levels dramatically began to rise. This raised suspicion for NED, and 68Ga-DOTATATE was done showing sufficient uptake to consider a trial of 177Lu-DOTATATE. The patient reported pain response, and PSA levels dropped after 1 cycle of the treatment.

Catheter malposition during a direct radionuclide cystography - case report.

We reported a 15-year-old girl with a history of mild left vesicoureteral reflux who underwent direct radionuclide cystography in our department. Bladder catheterization was mistakenly placed in the vagina. The filling phase showed vagina and uterine cavity which was similar to vesicoureteral reflux. The procedure was repeated with correct catheterization of the bladder and no vesicoureteral reflux was noted.

Detection of protein-losing enteropathy by 99m Tc-UBI scintigraphy.

nd localizing site of protein loss.

Multiple photopenic vertebrae in the bone scintigraphy of a young man with Gorham disease: CT and MRI correlation.

We report a rare pattern of extensive bone abnormalities on the Tc-99m MDP bone scintigraphy in a patient with Gorham disease. This rare condition is the result of vascular and lymphatic channel proliferation in bony structures which induce bone resorption. Our case is a 28-year-old man with a history of biopsy-proven soft tissue hemangioma in the left thigh, encountered with a recent diagnosis of multiple vertebral hemangiomata in the axial skeleton and progressive bony destructions in the pelvis on CT and MRI images, referred for bone scintigraphy. Multiple photopenic hemangiomata were noted on bone scan.