Multimodales Therapiekonzept bei metastasiertem folliculären Schilddrüsencarcinom mit Hyperthyreose

Abstract

The coincidence of hyperthyroidism and thyroid carcinoma seldom occurs. Only few reports on functionally metastases of thyroid carcinoma have been published. We report a 59-year-old man who underwent subtotal thyroidectomy for toxic nodular goiter. Histological examination revealed a follicular thyroid carcinoma. After thyroidectomy and cervical lymphadenectomy the patient developed a strong hyperthyreosis. Scintigraphy showed strong radioiodine uptake in the sacrum. De-bulking resection of the metastasis followed by high-dose radioiodine treatment was performed. After radioiodine therapy the patient became euthyroid. Treatment of hyperthyreosis in metastatic thyroid cancer requires a multimodal therapeutic concept.

Excellent Response to Multimodal Therapy Approach in Hyperfunctioning Metastatic Follicular Thyroid Carcinoma Diagnosed on 123I-SPECT/Ultrasound Fusion Imaging

“…Fracture-prone osteolysis of the right acetabulum required additional external radiation therapy (35 Gy). 9 Follow-up proved good response of nearly all metastases, with the only remaining vital cancer manifestation in parts of the right acetabulum (C1/C2). Perspectively, second radiation approach is planned.…”

“…Perspectively, second radiation approach is planned 7 . The presented case demonstrates successful theranostics of a rare case of hyperfunctional metastatic thyroid carcinoma 2,4,7,9 . Its detection was achieved by 123 I-SPECT/US fusion imaging that has not been introduced so far.…”

“…The following second 131 I radioiodine therapy was conducted 4 months after the first treatment ( B1 / B2 ). Fracture-prone osteolysis of the right acetabulum required additional external radiation therapy (35 Gy) 9 . Follow-up proved good response of nearly all metastases, with the only remaining vital cancer manifestation in parts of the right acetabulum ( C1 / C2 ).…”

“…7 The presented case demonstrates successful theranostics of a rare case of hyperfunctional metastatic thyroid carcinoma. 2,4,7,9 Its detection was achieved by 123 I-SPECT/US fusion imaging that has not been introduced so far. The technique of US fusion itself is well-described as a problem-solving tool.…”