April, 2003 -- According to experts, when papillary and follicular thyroid cancer -- the most common forms of thyroid cancer -- recur, they most commonly recur in the neck, either in the thyroid bed itself or in cervical lymph nodes. Experts looked at the effectiveness of iodine-131 (I-131) imaging (scanning), ultrasonography, and measurement of serum thyroglobulin levels as ways to detect recurrent neck tumor in differentiated thyroid cancer patients.

The patients all had total thyroidectomies, received similar doses of I-131 for remnant destruction, and had undetectable thyroglobulin levels right after treatment. All patients were on suppressive levothyroxine doses maintaining TSH at less than .05. At six and 12 months, the patients were evaluated by ultrasound, thyroglobulin tests, and whole-body I-131 scans conducted 28 days after stopping levothyroxine, when patients' mean TSH was 63.

The researchers found that recurrent thyroid carcinoma was detected in the neck at a mean time of approximately 45 months after diagnosis in 10 percent of patients. Forty-two patients had papillary carcinoma (recurrence rate, 10 percent), and 9 patients had follicular carcinoma (recurrence rate, 13 percent). The neck recurrence was detected by ultrasound in 48 of the 51 patients (94 percent). I-131 uptake was seen in the neck of only 23 patients (45 percent). And elevated thyroglobulin levels were seen in only 29 patients (57 percent).

This substantial difference in detection rates led researchers to conclude that ultrasonography of the neck is more sensitive than I-131 scanning or serum thyroglobulin measurements for detecting recurrence of differentiated thyroid cancer in the neck.

Reference: Frasoldati A, et. al. "Diagnosis of neck recurrences in patients with differentiated thyroid carcinoma," Cancer 2003; 97: 90-6.

MORE INFORMATION ON THYROID CANCER
Thyroid Cancer Links
Latest Thyroid Cancer Links