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Thyroglobulin flare response after radioiodine ablation in 2 patients with differentiated thyroid cancer
James F Tsang1, Daniel P Levin, William D Leslie
1From the Section of Nuclear Medicine, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Abstract:
Serum thyroglobulin (Tg) measurement facilitates monitoring differentiated thyroid cancer. We describe 2 patients with papillary thyroid cancer who developed dramatic transient serum Tg level elevations within 1 week of I radioiodine (RAI) ablation without cancer recurrence on follow-up. The first patient received recombinant human thyroid-stimulating hormone injections. The pre-injection Tg level was 3.8 μg/L and increased to 3060 μg/L 3 days post-RAI. In the second patient, the serum Tg level increased from 1.3 μg/L to 209.9 μg/L 7 days after RAI. This transient early serum Tg "flare response" could be misleading if interpreted as suggesting more extensive high-risk thyroid cancer.
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