PMC9393697_01
(A) Hematoxylin and eosin (H&E) staining showing follicular thyroid cancer cells (magnification x100). (B) Hematoxylin and eosin (H&E) staining showing lymph node metastasis from follicular thyroid cancer (magnification x100). (C) Whole-body iodine scan showed radioactive iodine refractory.
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In 2015, the patient was diagnosed with DTC (Figures 1A, B) and received radical thyroidectomy and subsequent RAI therapy. However, his pulmonary lesions did not take iodine revealed by whole-body iodine scan after last RAI therapy in October 2019 (Figure 1C).
(A) Timeline of the reported case. (B) Chest computed tomography (CT) scanning showed change of a pulmonary lesion which was located in the left lower lobe of the lung. (C) Chest CT scanning showed change of a subcarinal lymph node lesion. (D) Change in the serum thyroglobulin (Tg) level in each assessment.
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During the first 6 months' assessment, the combination therapy initially showed disease control in terms of both stable structural lesions and biochemical thyroglobulin (Tg) level (Figure 2). April 2021, the targeted and non-targeted lesions began to shrink rapidly followed by a rapid decrease in serum Tg, and a partial response (PR) according to RECIST 1.1 criteria was finally achieved upon 12 months' assessment in October 2021 (targeted lesions: 4.7 to 2.9 cm) (Figures 2B, C). Along with this process, the biochemical Tg level also decreased from 22,481 ng/ml (October 2020) to 5,351 ng/ml (October 2021) (Figure 2D).