Metastatic papillary thyroid cancers with malignant pleural effusion aggravated during thyroid hormone withdrawal for radioiodine therapy
- Authors
- 서지혜; 제지혜; 이현정; 나영주; 정일우; 안지현; 김신곤; 최동섭; 김남훈
- Issue Date
- 2015
- Publisher
- 영남대학교 의과대학
- Keywords
- Thyroid neoplasms; Thyroid hormones; Malignant pleural effusion
- Citation
- Yeungnam University Journal of Medicine, v.32, no.2, pp 138 - 142
- Pages
- 5
- Journal Title
- Yeungnam University Journal of Medicine
- Volume
- 32
- Number
- 2
- Start Page
- 138
- End Page
- 142
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/30114
- DOI
- 10.12701/yujm.2015.32.2.138
- ISSN
- 2384-0293
2384-0293
- Abstract
- L-thyroxine (LT4) withdrawal prior to radioactive iodine (RAI) ablation therapy is a commonly used method for successful treatment of patients with papillary thyroid cancer (PTC). However, a prolonged period of hypothyroidism induced by LT4 withdrawal is sometimes associated with impaired quality of life and cardiopulmonary dysfunction in PTC patients. Furthermore, LT4 withdrawal may have a trophic effect on residual cancer by means of increased thyrotropin. We report on 2 cases of metastatic PTC patients with malignant pleural effusion (MPE) whose disease showed rapid worsening after LT4 withdrawal and RAI therapy. The first case is a 65-year-old woman who had PTC with multiple distant metastases and MPE. During LT4 withdrawal for RAI therapy, MPE showed rapid worsening, and the patient required repetitive therapeutic thoracentesis. The second case is a 49-year-old woman with PTC who underwent 3 additional operations for cancer recurrence in the neck lymph nodes and 6 times of RAI treatments. While preparing for the 7th RAI treatment by withdrawing LT4, she developed MPE which became progressively aggravated after RAI therapy. Both patients experienced increased pleural effusion during the LT4 withdrawal period and a rise in the thyroglobulin level was observed after RAI therapy. MPE was not controlled with therapeutic thoracentesis and pleurodesis. Eventually, both patients died of rapid disease progression after RAI therapy. In summary, LT4 withdrawal may have an adverse effect on metastatic PTC patients, particularly those with MPE.
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- Appears in
Collections - 2. Clinical Science > Department of Endocrinology and Metabolism > 1. Journal Articles
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