TY - JOUR
T1 - Differentiated Thyroid Carcinoma After I-131-MIBG Treatment for Neuroblastoma During Childhood: Description of the First Two Cases
AU - van Santen, Hanneke M.
AU - Tytgat, Godelieve A. M.
AU - van de Wetering, Marianne D.
AU - van Eck-Smit, Berthe L. F.
AU - Hopman, Saskia M. J.
AU - van der Steeg, Alida F.
AU - Nieveen van Dijkum, Els J. M.
AU - van Trotsenburg, A. S. Paul
PY - 2012
Y1 - 2012
N2 - Background: It is well known that the thyroid gland is sensitive to the damaging effects of irradiation (X-radiation or I-131(-)). For this reason, during exposure to I-131-metaiodobenzylguanidine (MIBG) in children with neuroblastoma (NBL), the thyroid gland is protected against radiation damage by the administration of either potassium iodide (KI) or a combination of KI, thyroxine, and methimazole. Although hypothyroidism and benign thyroid nodules are frequently encountered during follow-up of these children, differentiated thyroid carcinoma (DTC) has never been reported after treatment with I-131-MIBG in children who have not been given external beam irradiation. Here, we describe the first two cases of DTC after I-131-MIBG-therapy. Patient Findings: A 6-year-old boy, treated with I-131-MIBG for NBL at the age of 4 months, and a 13-year-old girl, treated at the age of 9 months, were both diagnosed with DTC at 5 and 12 years after I-131-MIBG treatment, respectively. Both children received thyroid protection during exposure to I-131-MIBG. In each child DTC was discovered in nonpalpable nodules by thyroid ultrasound. Summary: The first two pediatric patients with DTC after treatment with I-131-MIBG are reported. Conclusions: Both these cases of DTC after I-131-MIBG for childhood NBL underline the importance of adequate thyroid protection against radiation exposure during treatment for NBL. Children who have been treated with I-131-MIBG should be given life-long follow-up, not only with regard to thyroid function, but also with surveillance for the development of thyroid nodules and thyroid cancer
AB - Background: It is well known that the thyroid gland is sensitive to the damaging effects of irradiation (X-radiation or I-131(-)). For this reason, during exposure to I-131-metaiodobenzylguanidine (MIBG) in children with neuroblastoma (NBL), the thyroid gland is protected against radiation damage by the administration of either potassium iodide (KI) or a combination of KI, thyroxine, and methimazole. Although hypothyroidism and benign thyroid nodules are frequently encountered during follow-up of these children, differentiated thyroid carcinoma (DTC) has never been reported after treatment with I-131-MIBG in children who have not been given external beam irradiation. Here, we describe the first two cases of DTC after I-131-MIBG-therapy. Patient Findings: A 6-year-old boy, treated with I-131-MIBG for NBL at the age of 4 months, and a 13-year-old girl, treated at the age of 9 months, were both diagnosed with DTC at 5 and 12 years after I-131-MIBG treatment, respectively. Both children received thyroid protection during exposure to I-131-MIBG. In each child DTC was discovered in nonpalpable nodules by thyroid ultrasound. Summary: The first two pediatric patients with DTC after treatment with I-131-MIBG are reported. Conclusions: Both these cases of DTC after I-131-MIBG for childhood NBL underline the importance of adequate thyroid protection against radiation exposure during treatment for NBL. Children who have been treated with I-131-MIBG should be given life-long follow-up, not only with regard to thyroid function, but also with surveillance for the development of thyroid nodules and thyroid cancer
U2 - https://doi.org/10.1089/thy.2011.0464
DO - https://doi.org/10.1089/thy.2011.0464
M3 - Article
C2 - 22524499
SN - 1050-7256
VL - 22
SP - 643
EP - 646
JO - Thyroid
JF - Thyroid
IS - 6
ER -