[Prevalence of iodine- and thyroglobulin-negative findings in differentiated thyroid cancer.A retrospective analysis of patients treated from 1951 to 1998 in university hospital]. / Häufigkeit lod- und hTG-negativer Befunde beim differenzierten Schilddrüsenkarzinom. Eine retrospektive Analyse der von 1961 bis 1998 in einer Universitätsklinik behandelten Patienten.

AIM: The prevalence of iodine- and thyroglobulin-negative findings was evaluated in all patients with differentiated thyroid cancer (DTC) treated from 1961 until 1998 at the Department of Nuclear Medicine, University Hospital Hamburg-Eppendorf. METHODS: A total of 490 patients with papillary thyroid cancer (PCA) and 242 patients with follicular thyroid cancer (FCA) were analyzed retrospectively. Patients were divided into four groups: 1: no recurrence, 2: recurrent disease, 3: primary metastatic/progressive disease and 4: inconclusive follow-up. Results of iodine scan, serum-TG, and additional imaging modalities as well as histology were compared in all patients. RESULTS: 21/490 (4.3%) of patients with PCA and 16/242 (6.6%) with FCA suffered from recurrent disease. 62/490 (12.7%) of patients with PCA and 59/242 (24.4%) with FCA had primary metastatic/progressive disease. 12/21 patients with PCA and 12/16 with FCA showing up with recurrent disease had a negative iodinescan. 11/21 of patients with PCA and 4/16 with FCA and tumor recurrence had negative serum-TG levels. 14/62 patients with PCA and 14/59 with FCA presenting with primary metastatic/progressive disease had negative iodinescan. 14/62 patients with PCA and 6/59 with FCA had negative serum-TG. CONCLUSION: The prevalence of iodine-negative recurrent/metastatic disease is in accordance to the literature, whereas the prevalence of TG-negative recurrent/metastatic was noted higher than reported previously. Thus, the commonly used follow-up scheme of DTC is confirmed. However, iodine scan should be regularly performed in patients with high risk of recurrence.

Pregnancy testing before high-dose radioiodine treatment: a case report.

This case emphasizes that negative urine pregnancy testing and a written declaration of the patient are not sufficient to safely exclude an early pregnancy. Serum pregnancy testing inherently has a diagnostic gap of about 1 wk following conception. We recommend sufficient contraception at least 1 mo before radioiodine treatment in women of childbearing age.