OXYPHILIC CARCINOMAS OF THE THYROID-GLAND - THE VALUE OF I-131 SCINTIGRAPHY

The aim of the study was to ascertain the role of I-131 scintigraphy ( RIS) in the follow-up of oxyphilic thyroid carcinomas (OTC). It is dis cussed that metastases (M) and local recurrencies (LR) are incapable o f accumulating I-131 sufficiently; therefore, the usual strategy of RI S cannot be used for follow-up. The re-examination of 91 patients suff ering from OTC showed that 10/20 patients with M/LR did have a positiv e uptake of I-131, which could be used for therapy in 8 patients. An a blation of M using high-dose I-131 therapy could be demonstrated in th ree younger patients who had cervical lymph node M 3 months after thyr oidectomy as an early manifestation of their disease. In three patient s RIS first led to the metastatic site. The clinical course of patient s with distant M that developed at a later stage was unfavourable, eve n though they did accumulate I-131. Patients with positive uptake of I -131 in M/LR were significantly younger (55a) than patients who had no uptake (67a) and belonged more often to stage I and II of UlCC, namel y 7/10 vs 2/10. RIS should be used especially in an early interval aft er thyroidectomy and individually for follow-up: as a diagnostic metho d and therapeutic instrument.