Abstract
We experienced a case of papillary carcinoma of thyroid with metastasis to liver and bone that responded well to the administration of I-131. The patient was a 34-year-old female who noticed a mass in her neck which gradually increased its size since 20 years old. The study of the mass revealed a intracapuslar papillary to cauliflower like tumor 9 cm in size without calcification in the right lobe of thyroid and a multifollicular tumor with unclear margin in left lower corner of the gland. Cytological study revealed class II in both tumors, but the serum thyroglobulin value showed extremely high level of 3670ng/ml (normal : <32.7ng/ml). CT study of cervico-thoracic area revealed no other lesions. With the preoperative diagnosis of adenoid thyroid tumor an operation was performed in March, 2002. Subtotal thyroidectomy was performed and the intraoperative frozen section study turned out to be negative in malignancy, however the postoperative pathological study revealed thyroid carcinoma (follicular type). The value of serum thyroglobulin returned to normal immediate postoperatively, but it was elevated again to 134ng/ml 16 months later. In July, 2005 the value went up to 4370ng/ml and new metastasis or recurrence of the tumor was suspected. A metastasis to the liver was found and total thyroidectomy was performed. I-131 scintigraphy revealed multiple bone metastases, for which administration of I-131 was done twice, resulting in decrease of serum thyroglobulin value and significant reduction of the size of liver metastasis and sclerotic changes of bone metastases and decreased accumulation in PET-CT study.
