open access

Vol 61, No 5 (2010)
Case report
Published online: 2010-11-04
Submitted: 2013-02-15
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A case of acromegaly and disseminated follicular thyroid carcinoma

Agata Bałdys-Waligórska, Filip Gołkowski, Anna Krzentowska, Grzegorz Sokołowski, Oleksandr Halytsky, Alicja Hubalewska-Dydejczyk
Endokrynologia Polska 2010;61(5):497-501.

open access

Vol 61, No 5 (2010)
Case report
Published online: 2010-11-04
Submitted: 2013-02-15

Abstract


Introduction: A particularly challenging case of concurrent acromegaly and follicular thyroid carcinoma in a patient of the Clinic of Endocrinology, UJCM in Krakow is discussed.
Case description: A 59-year-old male with post total thyroidectomy performed in 2005 and histopathologically confirmed metastases of the follicular thyroid carcinoma to the lungs was admitted to the Clinic in April 2006 for complementary 131I treatment. Acromegaly was treated in 1996 by trans-sphenoidal surgery. In December 2005 a relapse of pituitary adenoma was shown by MRI, which correlated with increased levels of hGH and IGF-1. Biochemical control of acromegaly was achieved with Sandostatin LAR. Pre-therapeutic whole-body scintigraphy (WBS) revealed numerous conjoined hot spots of 131I accumulation in both lungs and in thyroid remnants. In May and November 2006 the patient received 131I treatment. Post-therapeutic WBS in November 2006 revealed complete ablation of the thyroid remnants. Laboratory tests confirmed lowering of thyroglobulin concentration. In the years 2007, 2008, and 2009 the patient was qualified for therapy with 131I aided by rhTSH, achieving further reduction of Tg levels. Post-therapeutic WBS performed in 2009 revealed weak bilateral tracer uptake in the lung parenchyma. In 2010, chest CT revealed fibrosis in left lung segments, no infiltrative changes, and no lymph node enlargement. Patient follow-up continues at our Department.
Conclusions: Disseminated thyroid cancer in a patient with pituitary insufficiency may be successfully treated by rhTSH-supported 131I treatment.
(Pol J Endocrinol 2010; 61 (5): 497-501)

Abstract


Introduction: A particularly challenging case of concurrent acromegaly and follicular thyroid carcinoma in a patient of the Clinic of Endocrinology, UJCM in Krakow is discussed.
Case description: A 59-year-old male with post total thyroidectomy performed in 2005 and histopathologically confirmed metastases of the follicular thyroid carcinoma to the lungs was admitted to the Clinic in April 2006 for complementary 131I treatment. Acromegaly was treated in 1996 by trans-sphenoidal surgery. In December 2005 a relapse of pituitary adenoma was shown by MRI, which correlated with increased levels of hGH and IGF-1. Biochemical control of acromegaly was achieved with Sandostatin LAR. Pre-therapeutic whole-body scintigraphy (WBS) revealed numerous conjoined hot spots of 131I accumulation in both lungs and in thyroid remnants. In May and November 2006 the patient received 131I treatment. Post-therapeutic WBS in November 2006 revealed complete ablation of the thyroid remnants. Laboratory tests confirmed lowering of thyroglobulin concentration. In the years 2007, 2008, and 2009 the patient was qualified for therapy with 131I aided by rhTSH, achieving further reduction of Tg levels. Post-therapeutic WBS performed in 2009 revealed weak bilateral tracer uptake in the lung parenchyma. In 2010, chest CT revealed fibrosis in left lung segments, no infiltrative changes, and no lymph node enlargement. Patient follow-up continues at our Department.
Conclusions: Disseminated thyroid cancer in a patient with pituitary insufficiency may be successfully treated by rhTSH-supported 131I treatment.
(Pol J Endocrinol 2010; 61 (5): 497-501)
Get Citation

Keywords

acromegaly; disseminated follicular thyroid cancer

About this article
Title

A case of acromegaly and disseminated follicular thyroid carcinoma

Journal

Endokrynologia Polska

Issue

Vol 61, No 5 (2010)

Pages

497-501

Published online

2010-11-04

Bibliographic record

Endokrynologia Polska 2010;61(5):497-501.

Keywords

acromegaly
disseminated follicular thyroid cancer

Authors

Agata Bałdys-Waligórska
Filip Gołkowski
Anna Krzentowska
Grzegorz Sokołowski
Oleksandr Halytsky
Alicja Hubalewska-Dydejczyk

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