MANAGEMENT OF PATIENTS WITH DIFFERENTIATED THYROID-CANCER WHO HAVE POSITIVE SERUM THYROGLOBULIN LEVELS AND NEGATIVE RADIOIODINE SCANS

Most current evidence suggests that patients with papillary or follicu lar thyroid cancer after total thyroidectomy who are Tg positive (Tg g reater than or equal to 10 ng/mL) and radioactive iodine scan negative warrant treatment with 100 mCi of I-131 With a follow up scan and Tg determination. If isolated focal metastatic deposits are present they should be resected before treatment with radioiodine. Although some ph ysicians might recommend radioiodine treatment only for high risk pati ents, we would recommend it for all patients with elevated serum Tg le vels that increase after TSH stimulation, or until further information becomes available to support a different approach.