Severity: Warning
Message: file_get_contents(https://...@pubfacts.com&api_key=b8daa3ad693db53b1410957c26c9a51b4908&a=1): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
Filename: helpers/my_audit_helper.php
Line Number: 176
Backtrace:
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 176
Function: file_get_contents
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 250
Function: simplexml_load_file_from_url
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 3122
Function: getPubMedXML
File: /var/www/html/application/controllers/Detail.php
Line: 575
Function: pubMedSearch_Global
File: /var/www/html/application/controllers/Detail.php
Line: 489
Function: pubMedGetRelatedKeyword
File: /var/www/html/index.php
Line: 316
Function: require_once
Objective: Differentiated thyroid cancer (DTC) is one of the fastest growing cancers worldwide. Despite the generally good prognosis of thyroid carcinoma, about 5% of patients will develop metastatic disease, exhibiting a more aggressive behavior. Radioiodine whole-body scintigraphy (WBS) has been used in the detection of DTC. Radioiodine is a sensitive marker for detection of thyroid cancer; however, radioiodine uptake is not specific for thyroid tissue. It can also be seen in healthy tissue as well as in inflammation, or in a variety of benign and malignant non-thyroidal entities.
Subject And Methods: The subject of the present case report is a 52 years old man with brain metastatic DTC who received radioiodine therapy and corticosteroids as palliative therapy. Whole-body scintigraphy revealed bilateral iodine uptake of the femur. Corticosteroid therapy is among the most widely recognized risk factor for osteonecrosis, which at the present case had to be recognized as a false positive (iodine-131) I uptake in order to avoid diagnostic error.
Results: Post therapeutic whole body scintigraphy revealed no uptake in the thyroid bed as well as pathologic uptake of radioiodine in both femurs. The magnetic resonance imaging (MRI) of the femurs combined with the history of long term exposition on high doses of corticosteroids evidenced diagnosis of steroid-induced osteonecrosis of the femurs.
Conclusion: Radioiodine WBS plays an important role in clinical decision making for the evaluation and the management of patients with DTC. Despite its high range of sensitivity and specificity, a variety of reports of false positive whole body scans has demonstrated a diversity of causes. Comprehension of the physiology of iodine uptake and of the pathophysiology of clinical entities which end up giving false positives scans, provides clinicians a useful tool in order to avoid diagnostic and therapeutic errors as far as DTC is concerned.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1967/s002449912556 | DOI Listing |
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!