Radioactive iodine therapy in poorly differentiated thyroid cancer

Poorly differentiated thyroid cancers (PDTCs) are usually aggressive tumors with high rates of recurrence and distant metastases that are often resistant to radioactive iodine therapy. Tuttle and colleagues present the case of a 55-year-old man who was diagnosed with metastatic PDTC and was managed with radioactive iodine therapy. The authors discuss the current management options for patients with PDTCs that are nonresponsive to RAI therapy and highlight the need for the discovery of new systemic treatments for these patients. Background A 55-year-old male was diagnosed with poorly differentiated thyroid cancer after total thyroidectomy, which was performed because of progressive enlargement of a dominant thyroid nodule. He developed an early cervical recurrence that was treated with modified neck dissection. He subsequently developed biopsy-proven progressive pulmonary metastases. Investigations Neck and chest CT scans, laboratory tests, CT-guided fine-needle aspiration biopsy, [ 18 F]-2-fluoro-2-deoxy-D-glucose-PET scan, lesional dosimetry using 124 I PET scan, diagnostic radioactive iodine (RAI) scanning, whole-body and blood RAI dosimetry, and single-photon-emission CT. Diagnosis Stage IV poorly differentiated thyroid cancer. Management Surgical resection of cervical recurrence, RAI therapy.