Recombinant Human Thyrotropin-Aided Radioiodine Therapy in Tracheal Obstruction by an Invading Well-Differentiated Thyroid Carcinoma

• Main Authors: Nickolaos Pontikides, Spyridon Karras, Antonios Papagiannis, Athina Kaprara, Panagiotis Anagnostis, George Noussios, Argyrios Doumas, Apostolos Goropoulos, Ioannis Iakovou, Georgios Kotronis, Konstantinos Bantis, Gerasimos Krassas
• Format: Article
• Language: English
• Published: Hindawi Limited 2013-01-01
• Series: Case Reports in Otolaryngology
• Online Access: http://dx.doi.org/10.1155/2013/579527
• ISSN: 2090-6765; 2090-6773

Papillary thyroid carcinomas (PTCs) usually extend to lymph nodes in the neck and mediastinum. Rarely, they invade the neighboring upper airway anatomical structures. We report a 56-year-old woman who presented with symptoms of upper airway obstruction. Imaging studies revealed a lesion derived from the thyroid which invaded and obstructed the trachea, which appeared to be a highly differentiated PTC. Total thyroidectomy was performed, with removal of the endotracheal part of the mass along with the corresponding anterior tracheal rings. Two months later, a whole body I131 scan after recombinant human thyroid-stimulating hormone (rh-TSH) administration was performed and revealed a residual mass in upper left thyroid lobe. Subsequently, 150 mCi I131 were given following rh-TSH administration. Nine months later, there was no sign of residual tumor. This case is the first one reported in the literature regarding rh-TSH administration prior to RAI ablation in a PTC obstructing the trachea.