Massive rise in thyroglobulin with adult respiratory distress syndrome after embolisation of thyroid cancer metastasis.

Abstract

A patient with long-standing metastatic disease from a well differentiated papillary cell carcinoma of the thyroid underwent embolisation of a painful large sacral metastasis. Following embolisation she had a massive rise in circulating serum thyroglobulin (Tg) levels coinciding with the development of adult respiratory distress syndrome (ARDS) on the tenth day without any other obvious cause. The patient subsequently recovered. The time course suggests that ARDS in this case might have resulted from aggregation of Tg molecules in the pulmonary microcirculation.

Selective embolization of thyroid arteries as a preresective and palliative treatment of thyroid cancer

“…The review of literature did not help us to elucidate potential consequences of increased serum Tg concentration. However, in the earlier study, the authors described that embolization of DTC metastases caused massive Tg increase, which, probably, resulted in adult respiratory distress syndrome (Elshafie et al 2000). Considering the above, we suggest performing thyroidectomy up to the 36 h after preresective SETA, as till that time we did not observe any important increase in the concentration of the parameters in question.…”

Evaluation of selective embolization of thyroid arteries (SETA) as a preresective treatment in selected cases of toxic goitre

“…Moreover, the review of the literature did not help us elucidate any potential consequences of increased serum Tg concentration. However, in one earlier study, its authors described embolization of DTC metastases to have caused massive Tg increase, which – probably – resulted in adult respiratory distress syndrome [ 18 ]. Considering the above observation, we suggested thyroidectomy to be performed till the 36 th hour after preresective SETA, as till that time, we did not observe in our study any significant increase in concentrations of the parameters in question [ 9 ].…”

Embolization Therapy of Bone Metastases from Epithelial Thyroid Carcinoma: Effect on Symptoms and Serum Thyroglobulin

“…Several case reports with embolization therapy in the treatment of thyroid cancer are described (5)(6)(7)(8)(9)(10). Few reports, including one report written by our group, deal with embolization therapy for bone metastasis in thyroid cancer (11,12); others concern direct embolization of the primary thyroid tumor (13,14) or the use of embolization as a preoperative procedure (15)(16)(17)(18).…”