PREOPERATIVE MARKING OF LOCAL RELAPSE OF METASTASES OF DIFFERENTIATED THYROID-CARCINOMA WITH I-131 - AN INTEGRATED THERAPEUTIC APPROACH

In the treatment of differentiated thyroid carcinoma local tumor relapse or metastases to cervical lymph nodes represent a therapeutical challenge. Tumor localization after repeated surgery is difficult, since anatomic structures have been destroyed. Moreover, a sufficiently high radiation dose can not be delivered to the tumor in all cases. A therapeutical approach is presented which facilitates intrasurgical localization of malignant tissue and allows an instant assessment of the operation success. In nine patients with local relapse or lymph node metastases of differentiated thyroid carcinoma radioiodine was applied before surgery. All functioning metastases could be localized and in most cases removed entirely. Radioiodine activity necessary for complete tumor ablation was considerably diminished. Eight out of nine patients remained free from recurrent tumor up to 42 months after therapy in spite of advanced primary tumor stages.