SUPPRESSION OF THE TSH RESPONSE TO TRH BY THYROXINE THERAPY IN DIFFERENTIATED THYROID CARCINOMA PATIENTS

1979 ◽  
Vol 91 (2) ◽  
pp. 248-256 ◽  
Author(s):  
B.-A. Lamberg ◽  
Marja Rantanen ◽  
Pirkko Saarinen ◽  
K. Liewendahl ◽  
A. Sivula
Keyword(s):  
Thyroid Carcinoma ◽  
Thyroid Tissue ◽  
Reference Interval ◽  
Differentiated Thyroid Carcinoma ◽  
Thyrotrophin Releasing Hormone ◽  
Thyroxine Therapy ◽  
Trh Stimulation ◽  
Tsh Secretion ◽  
Adequate Dosage ◽  
The Individual

ABSTRACT Absent response of serum thyrotrophin (TSH) after stimulation with 200 μg synthetic thyrotrophin-releasing hormone (TRH) was used as a criterion of adequate suppression of TSH secretion in the treatment of thyroid carcinoma patients with thyroxine. The mean causing total suppression of the response was 223 μg of thyroxine per day. At this dose level about 40 % of the patients had serum thyroxine concentrations above the upper reference interval and only 10 % had elevated triiodothyronine concentrations. In some patients the TSH response to TRH varied between absent and low normal when tested at long intervals. The ideal dose of thyroxine is obviously slightly higher than the smallest one causing total suppression of the TSH response to TRH, i.e. about 250 μg a day. The individual dose must be found using the TRH stimulation test because serum thyroid hormone levels cannot be used as a guideline for adequate dosage. In some patients the thyroid remnant of apparently normal thyroid tissue was not totally suppressed although the thyroxine dose was definitely above the level causing suppression of the response to TRH.

Use of radioiodine-131 scan to measure influence of surgical discipline, practice, and volume on residual thyroid tissue after total thyroidectomy for differentiated thyroid carcinoma

Head & Neck ◽  
2018 ◽  
Vol 40 (10) ◽  
pp. 2129-2136 ◽  
Author(s):  
Jin Soo A. Song ◽  
Nico Moolman ◽  
Steven Burrell ◽  
Murali Rajaraman ◽  
Martin Joseph Bullock ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
Thyroid Tissue ◽  
Differentiated Thyroid Carcinoma

scholarly journals Optimization of Predictive Performance for the Therapeutic Response Using Iodine Scan-Corrected Serum Thyroglobulin in Patients with Differentiated Thyroid Carcinoma

Cancers ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 262
Author(s):  
Su Woong Yoo ◽  
Md. Sunny Anam Chowdhury ◽  
Subin Jeon ◽  
Sae-Ryung Kang ◽  
Sang-Geon Cho ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Thyroid Tissue ◽  
Predictive Performance ◽  
Response Prediction ◽  
Differentiated Thyroid Carcinoma ◽  
Whole Body ◽  
Serum Thyroglobulin ◽  
Focal Uptake ◽  
Uptake Pattern ◽  
Iodine Scan

We investigated whether the performance of serum thyroglobulin (Tg) for response prediction could be improved based on the iodine uptake pattern on the post-therapeutic I-131 whole body scan (RxWBS) and the degree of thyroid tissue damage with radioactive iodine (RAI) therapy. A total of 319 patients with differentiated thyroid carcinoma who underwent total thyroidectomy and RAI therapy were included. Based on the presence/absence of focal uptake at the anterior midline of the neck above the thyroidectomy bed on RxWBS, patients were classified into positive and negative uptake groups. Serum Tg was measured immediately before (D0Tg) and 7 days after RAI therapy (D7Tg). Patients were further categorized into favorable and unfavorable Tg groups based on the prediction of excellent response (ER) using scan-corrected Tg developed through the stepwise combination of D0Tg with ratio Tg (D7Tg/D0Tg). We investigated whether the predictive performance for ER improved with the application of scan-corrected Tg compared to the single Tg cutoff. The combined approach using scan-corrected Tg showed better predictive performance for ER than the single cutoff of D0Tg alone (p < 0.001). Therefore, scan-corrected Tg can be a promising biomarker to predict the therapeutic responses after RAI therapy.

Multicenter Study Differentiated Thyroid Carcinoma (MSDS)

2003 ◽  
Vol 42 (06) ◽  
pp. 244-250 ◽  
Author(s):  
M. K. Pixberg ◽  
A. Schuck ◽  
A. Heinecke ◽  
W. Köpcke ◽  
K. W. Schmid ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Randomized Trial ◽  
Multicenter Study ◽  
External Beam Radiotherapy ◽  
Differentiated Thyroid Carcinoma ◽  
Steering Committee ◽  
Clinical Event ◽  
External Beam ◽  
Thyroxine Therapy ◽  
Number Of Patients

Summary Aim: The Multicenter Study Differentiated Thyroid Carcinoma (MSDS) is an ongoing study in Germany, Austria, and Switzerland on the clinical benefit of adjuvant external beam radiotherapy (RTx) for locally invasive differentiated thyroid carcinoma (DTC) in TNM stages pT4 pN0/1/x M0/x (5th ed. 1997). Methods: MSDS was designed as a prospective randomized trial. Patients receive thyroidectomy, radioiodine therapy (RIT) to ablate the thyroid remnant, and TSH-suppressive L-thyroxine therapy with or without RTx after documented elimination of cervical iodine-131 uptake (http://msdsstudie.uni-muenster.de). Results: 311 patients were enrolled between January 2000 and March 2003. 279 patients met the trial’s inclusion criteria. 45 consented to randomization, of whom 17 were randomized into treatment arm A (RTx) and 18 into arm B (no RTx).Advised by the trial’s independent Data Monitoring and Safety Committee, the MSDS steering committee decided to terminate randomization in April 2003 and continue MSDS as a prospective cohort study. 23 of the 234 patients in the observation arm of the trial were prescribed RTx by their physicians. Thus, 14% of the trial cohort were randomized or assigned to receive RTx (intention-to-treat analysis). In contrast, at least 44% of all patients with pT4 papillary DTC in Germany in the nationwide PCES study underwent RTx in 1996 (p <0.001, χ2-test). Conclusions: Acceptance of external beam RTx as a treatment modality for DTC has receded to a degree that accrual of a sufficient number of patients for a randomized trial has been impossible. Observation of the trial cohort is continued in order to assess clinical event rates with and without RTx and chronic RTx toxicity.

Low versus high radioiodine dose in postoperative ablation of residual thyroid tissue in patients with differentiated thyroid carcinoma

2012 ◽  
Vol 33 (3) ◽  
pp. 275-282 ◽  
Author(s):  
Babak Fallahi ◽  
Davood Beiki ◽  
Abbas Takavar ◽  
Armaghan Fard-Esfahani ◽  
Kianoush Ansari Gilani ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Thyroid Tissue ◽  
Differentiated Thyroid Carcinoma

scholarly journals Poorly Differentiated Thyroid Carcinoma Arising in Struma Ovarii

2015 ◽  
Vol 2015 ◽  
pp. 1-6
Author(s):  
Surapan Khunamornpong ◽  
Jongkolnee Settakorn ◽  
Kornkanok Sukpan ◽  
Prapaporn Suprasert ◽  
Sumalee Siriaunkgul
Keyword(s):  
Differential Diagnosis ◽  
Thyroid Carcinoma ◽  
Ovarian Neoplasms ◽  
Mature Teratoma ◽  
Thyroid Tissue ◽  
Differentiated Thyroid Carcinoma ◽  
Endometrioid Adenocarcinoma ◽  
Struma Ovarii ◽  
Poorly Differentiated Thyroid Carcinoma ◽  
Poorly Differentiated

Struma ovarii is an uncommon type of ovarian mature teratoma with a predominant thyroid component. The morphological spectrum of the thyroid tissue ranges from that of normal thyroid to proliferative adenoma-like lesions and thyroid-type carcinomas (malignant transformation). The histologic features of ovarian strumal lesions sometimes cause diagnostic problems due to the confusion with other types of ovarian neoplasms and the difficulty in the prediction of their clinical behavior. We report an extremely rare case of poorly differentiated thyroid carcinoma arising in struma ovarii. A 22-year-old woman presented with a 15 cm right ovarian mass. The tumor showed a predominantly tubular pattern which raised a differential diagnosis between endometrioid adenocarcinoma and Sertoli cell tumor. A review of the gross specimen with additional tissue sampling helped identify the teratomatous and strumal nature, with a support by immunohistochemical staining. Despite FIGO stage IA by optimal staging procedure and the absence of identifiable lymphovascular invasion, the patient developed pulmonary metastasis 15 months after surgery and died from the progression of the disease 7 years after the diagnosis. This case emphasizes the importance of macroscopic examination of the specimen and the awareness of this uncommon tumor in the differential diagnosis of ovarian neoplasms.

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