PAPILLON SEMINARS on THYROID ULTRASOUND

Case 3 (case 1013)

 

First examination

Clinical presentation: A 34-yr-old woman was referred for evaluation of elevated thyroglobulin level. She was operated on and got radioiodine therapy for a T1bN1 papillary thyroid cancer 16 years ago. Four years ago, radioiodine therapy was applied because of a 17 mm large lymph node right to the trachea. Recently, the thyroglobulin level proved be elevated.

Palpation: no abnormality.

Laboratory tests: thyroglobulin 4.5 microgram/L, anti-hTg 6.1 U/mL.

Part 2: eight months after the previous visit

Clinical presentation: A few weeks after the previous examination, the larger lesion right to the right thyroid bed was removed and thereafter, radioiodine therapy was applied. On-thyroglobulin was normal. The patient was referred for ultrasound examination.

Palpation: no abnormality.

Laboratory tests: on-thyroglobulin 0.2 microgram/L, anti-hTg 4.8 U/mL.

Part 3: six months after the previous examination

Clinical presentation: After the ultrasound examination, thyroglobulin determination was applied by rhTSH and resulted in 4.5 microgram/L. A repeat radioiodine was performed 4 months ago.

Palpation: no abnormality.

Laboratory tests: thyroglobulin with rhTSH 0.1 microgram/L, anti-hTg 7.9 U/mL.