[Non-iodine-absorbing metastasis of differentiated thyroid cancer--therapeutic probe with 13-cis retinoic acid]. / Niejodochwytne przerzuty zróznicowanego raka tarczycy--próba terapii kwasem 13-cis-retinowym.

The absence of iodine uptake in metastases of differentiated thyroid carcinoma makes them unresponsive to treatment with radioiodine 131I. In many of such cases symptomatic treatment remains the only available therapy. The results of studies on partial redifferentiation of metastases of thyroid cancer achieved after cis-retinoid acid therapy have drawn attention to the possibility of restoration of iodine uptake in metastases after pretreatment with cis-retinoic acid (Roaccutane). 5 patients with iodine uptake-negative metastases of differentiated thyroid carcinoma were given Roaccutane in a dose 1.5 mg/kg/24 h daily for 6 weeks before the therapy with radioiodine. In none of the patients restoration of radioiodine uptake in metastases has occurred as shown in post-therapeutic total body scintigraphy.

[99mTc Tetrofosmin in diagnosis of distant metastases from differentiated thyroid cancer]. / 99mTc Tetrofosmin w diagnostyce przerzutów odleglych zróznicowanego raka tarczycy.

UNLABELLED: Technetium 99mTc(TF), non-specific tumor-searching tracer was evaluated for its ability to detect distant metastases of differentiated thyroid carcinoma (DTC) and its reliability in the follow-up of DTC. Whole body scintigraphy (wbs) was performed 20-30 min after intravenous injection of 740 MBq 99mTc tetrofosmin by means of a dual-head gamma-camera (followed by spot images if needed) in 61 patients (pts) with DTC; 52 pts with distant metastases in 131I whole body scintigraphy (34) or in other methods (x-ray, CT, ultrasound) (7) or with negative 131I whole body scan and elevated thyroglobulin (11). In the group of 52 pts with signs of neoplasm dissemination, 36 showed positive TF whole body scan (69%), 16 (31%) pts were TF-negative. 23 of 34 131I positive wbs were also TF positive (68%), 11 out of 34 were TF negative (32%). In a group of 7 pts with metastases in x-ray, CT or ultrasound 4/7 were positive (57%), 3/7 were TF negative (18%). In a control group of 11 persons (2 diseases-free, 9 with DTC in clinical remission) TF whole body scans were negative in all cases. CONCLUSIONS: Technetium 99mTc tetrofosmin is clinically useful for detecting distant metastases of differentiated thyroid carcinoma and deserves complementary clinical application in follow-up in such patients.

[Parathyroid hypofunction after total thyroidectomy for differentiated thyroid carcinoma--perspectives after long term observation and treatment]. / Niedoczynnosc przytarczyc po tyroidektomii calkowitej z powodu zróznicowanego raka tarczycy--perspektywa wieloletniej obserwacji i leczenia.

Hypoparathyroidism remains a serious complication of total thyroidectomy for differentiated thyroid carcinoma (DTC). In Brachytherapy Department 952 patients affected with DTC were followed up in the years 1996-2000. Radical total thyroidectomy was performed in 235 (24.6%) of cases, while the other 717 patients underwent complete rethyroidectomy. The incidence of hypoparathyroidism following radical operation and after complete rethyroidectomy was 15.74% and 23.43%, respectively. In patients operated in our institution, blood for calcium was analyzed daily for five days following the surgery. If calcium level was normal the next measurement was performed 4-5 weeks thereafter. Hypoparathyroidism was diagnosed later in postoperative period in many patients operated elsewhere. Asymptomatic hypocalcemia during the first week after the operation requires oral administration of calcium. If hypocalcemia requiring intravenous calcium supplementation does not resolve in a few days, vitamin 1(OH)D3 is introduced. Vitamin 1(OH)D3 and calcium carbonate play the main role in management of persistent hypocalcemia. In case of marked hypercalciuria thiazid diuretics are instituted. Low-phosphate diet is recommended. The aim of treatment of hypoparathyroidism is to restore normal serum calcium level with calciuria not exceeding 5 mg/kg/24 h, so to avoid hypocalcemic complications as well as vitamin D intoxication.

Evidence for alpha-adrenergic receptors mediated TSH release in men.

In order to elucidate the role of the adrenergic nervous system in the mechanism of TSH release in men the effects of alpha- and beta-receptors blocking agents were studied in 11 healthy volunteers. Phentolamine administered iv as a bolus injection in a dose of 10 mg, significantly lowered the TSH release in basal condition and in response to TRH stimulation. However, propranolol in a dose of 0.1 mg/kg administered in the same fashion as phentolamine had no effect on the TSH secretion. The results obtained suggest that the alpha-receptors of the adrenergic system are involved in the physiological mechanism which stimulates TSH release in men.