Augmentation of Radioiodine Uptake by Pulmonary Metastasis of Papillary Thyroid Carcinoma Treated with Dabrafenib and Trametinib

Redifferentiation therapy with Dabrafenib (a BRAF inhibitor) and Trametinib (a MEK inhibitor) restores radioiodine avidity of radioiodine-refractory papillary thyroid carcinoma (PTC). A 50-year-old man was diagnosed with radioiodine-refractory PTC pulmonary metastasis post prior total thyroidectomy and radioiodine ablation. The patient was treated with Dabrafenib and Trametinib, followed by second radioiodine ablation with I-131 sodium iodine. Diffuse increased radioiodine uptake by pulmonary metastasis was visualized on post ablation whole body scan. Response to second radioiodine ablation was demonstrated by decrease in size of pulmonary nodules seen on chest CT, along with decrease of thyroglobulin level.