How to Manage Patients with Differentiated Thyroid Cancer and a Rising Serum Thyroglobulin Level - 01/06/14

Doi : 10.1016/j.ecl.2014.02.002

Rossella Elisei, MD ^⁎ , Laura Agate, MD, David Viola, MD, Antonio Matrone, MD, Agnese Biagini, MD, Eleonora Molinaro, MD
Endocrinology Unit, Department of Clinical and Experimental Medicine, WHO Collaborating Center for the Study and Treatment of Thyroid Diseases and Other Endocrine and Metabolic Disorders, University of Pisa, Via Paradisa 2, Pisa 56124, Italy

^∗Corresponding author. Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Paradisa 2, Pisa 56124, Italy.

Resumen

Serum thyroglobulin (sTg) is the marker for monitoring persistence/recurrence of differentiated thyroid cancer, in patients without sTg antibodies. Patients with undetectable basal sTg or peak sTg <2 ng/mL are cured with low risk to recur. Newly detectable level of sTg indicates the recurrence. The significance of increasing sTg in patients treated with emithyroidectomy or total-thyroidectomy but not ablated with radioiodine is undefined. A doubling time <1 year may be a poor prognostic factor, but this is more relevant in cases with high levels of sTg. Because of its sensitivity, neck ultrasound should be performed at any visit, especially when an increased sTg is seen.

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Keywords : Differentiated thyroid carcinoma, Thyroglobulin, Recombinant human TSH, Thyroid hormones, 131-iodine