Gonadal damage due to radioactive iodine (I131) treatment for thyroid carcinoma

Abstract

Summary:Papillary carcinoma of the thyroid is the most common type of thyroid cancer and is associated with a good prognosis. Complications of treatment with surgery and radioiodine are uncommon. We report the case of a 13 year old boy who developed testicular damage following treatment with radioactive iodine 350 mCi for a papillary carcinoma of the thyroid. Four years after radioiodine treatment there has been no suggestion of recovery of spernatogenesis. Detailed follow-up studies of similarly treated young patients are required to define the incidence of this complication and to determine its reversibility.

Is Serum Thyroglobulin a Useful Marker for Thyroid Cancer in Patients Who Have Not Had Ablation of Residual Thyroid Tissue?

“…Radiation thyroiditis (27) and sialadenitis (28) can be troublesome. Late complications such as leukemia (11,12), sterility (13), radiation pneumonitis (14), and impaired marrow function (15) are rare and associated with large doses used to treat metastatic functioning cancer. These long-term problems would be unlikely in the majority of patients described in this arti¬ cle, because if 131I were to be prescribed it would most likely be a small dose such as 29.9 mCi (1,100 MBq) for those whose operation was subtotal to total thyroidectomy.…”

“…FT4 was measured by a two-step immunoradiometric as¬ say, whose characteristics have been reported previously (22). The normal range was 0.8-2.0 ng/dL (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26) pmol/L), quantitatively in the presence of anti-Tg (25). Originally the antibodies were measured by a method developed at Stanford (26), subsequently by the Kronus assay.…”

“…The risks are small, but have to be weighed against the risk of the disease itself. There are reports of an increase in leukemia (11,12), reduced sperm count (13), and in patients with lung and skeletal métastases, damage to pulmonary parenchyma (14) and marrow (15). It is true that these complications are greater when larger doses are prescribed to treat metastatic disease.…”

Trends in Paediatric Oncology and Potential Endocrine Sequelae

“…Here again the population under treatment is a very young one in whom the long-term effects of radioisotopes is un known but the dose of iodine is comparable with that used in ablative treatment of the thyroid. The thyroid is protected during MIBG treatment but the gonads are not, and evidence would suggest that gonadal damage may occur [5], Currently the largest percentage of survi vors of abdominal tumours are patients cured of Wilms' tumours. In the past many of these patients were treated with whole abdomen radiation which led to sterility in the girls.…”

Differentiated Thyroid Cancer

“…There are a few documented cases of reduced testicular function [328][329][330]. Pacini and colleagues studied 103 men who had been treated on average 15 months before [331].…”