TY - JOUR
T1 - Unsuccessful radioiodine treatment of a non-toxic goiter
T2 - a case report
AU - Hartoft-Nielsen, Marie-Louise
AU - Rasmussen, Ase Krogh
AU - Friis, Esbern
AU - Blichert-Toft, Mogens
AU - Buhl, Thora
AU - Hesse, Birger
AU - Feldt-Rasmussen, Ulla
N1 - Copyright 2004 Basic & Clinical Pharmacology & Toxicology
PY - 2004/8
Y1 - 2004/8
N2 - A middle-aged woman with a large right-sided, non-toxic goiter with low iodine uptake was admitted to the Department of Endocrinology with the purpose of volume reduction of the goiter. Thyroid pertechnetate scintigraphy showed homogenous and diffuse uptake in both lobes. Initially thyroxine treatment was given without volume-reducing effect. Radioiodine was administered twice to deliver a total radiation dose of 70 mCi iodine (I)-131. Subsequent pertechnetate scintigraphy showed that the normal-sized, normally functioning left lobe had disappeared after radioiodine, whereas the enlarged right lobe appeared unchanged. During the following years the size of the right lobe increased, and compression symptoms developed. The thyroid gland finally had to be removed by surgery. A large solitary thyroid nodule was removed, but no left lobe was identified. After surgery the patient had no thyroid tissue and had to be substituted by thyroid hormones. Despite good results of iodine treatment of non-toxic goiters, this case describes an unintended outcome leaving a patient without thyroid tissue, and a protracted course could have been avoided if the patient had undergone surgery earlier. However, this reported case should not discredit the use of radioiodine treatment of non-toxic goiters, but focus on patients with a single large solitary adenoma in whom this treatment may be inappropriate.
AB - A middle-aged woman with a large right-sided, non-toxic goiter with low iodine uptake was admitted to the Department of Endocrinology with the purpose of volume reduction of the goiter. Thyroid pertechnetate scintigraphy showed homogenous and diffuse uptake in both lobes. Initially thyroxine treatment was given without volume-reducing effect. Radioiodine was administered twice to deliver a total radiation dose of 70 mCi iodine (I)-131. Subsequent pertechnetate scintigraphy showed that the normal-sized, normally functioning left lobe had disappeared after radioiodine, whereas the enlarged right lobe appeared unchanged. During the following years the size of the right lobe increased, and compression symptoms developed. The thyroid gland finally had to be removed by surgery. A large solitary thyroid nodule was removed, but no left lobe was identified. After surgery the patient had no thyroid tissue and had to be substituted by thyroid hormones. Despite good results of iodine treatment of non-toxic goiters, this case describes an unintended outcome leaving a patient without thyroid tissue, and a protracted course could have been avoided if the patient had undergone surgery earlier. However, this reported case should not discredit the use of radioiodine treatment of non-toxic goiters, but focus on patients with a single large solitary adenoma in whom this treatment may be inappropriate.
KW - Denmark
KW - Disease Progression
KW - Drug Administration Schedule
KW - Female
KW - Goiter, Nodular/radiotherapy
KW - Humans
KW - Iodine/metabolism
KW - Iodine Radioisotopes/administration & dosage
KW - Medical History Taking/methods
KW - Middle Aged
KW - Radionuclide Imaging/methods
KW - Sodium Pertechnetate Tc 99m
KW - Thyroid Gland/anatomy & histology
KW - Thyroidectomy
KW - Thyroxine/administration & dosage
KW - Time Factors
KW - Treatment Failure
U2 - 10.1111/j.1742-7843.2004.950205.x
DO - 10.1111/j.1742-7843.2004.950205.x
M3 - Journal article
C2 - 15379783
SN - 1742-7835
VL - 95
SP - 72
EP - 75
JO - Basic & clinical pharmacology & toxicology
JF - Basic & clinical pharmacology & toxicology
IS - 2
ER -