Massive rise in thyroglobulin with adult respiratory distress syndrome after embolisation of thyroid cancer metastasis

A patient with long-standing metastatic disease from a well differentiated papillary cell carcinoma of the thyroid underwent embolisation of a painful large sacral metastasis. Following embolisation she had a massive rise in circulating serum thyroglobulin (Tg) levels coinciding with the development of adult respiratory distress syndrome (ARDS) on the tenth day without any other obvious cause. The patient subsequently recovered. The time course s uggests that ARDS in this case might have resulted from aggregation of Tg m olecules in the pulmonary microcirculation.