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Radioguided Surgery in Residual Mediastinal Disease Derived from Differentiated Iodine Negative Thyroid Cancer with Persistent Elevated Thyroglobulin Levels: A Case Report

Tommaso Zurleni, Baroli Alberto, Gjoni Elson, Di Mauro Enzo, Pedrazzini Luca, Ceriani Paola and Zurleni Francesco

The Radioguided Surgery (RGS) nowadays is used in many fields of oncology including thyroid tumours.

The peculiar characteristic of these procedures is the employment of isotopes that bind to the areas which need to be removed. We present a case of a residual mediastinal lesion derived from differentiated iodine negative thyroid cancer with persistent elevated thyroglobulin levels found by Scintigraphy Whole Body Scan + SPET/CT (111 In- DTPA-octreotide). RGS with radiolabeled somatostatin analogues in this case appears to be a useful method for real time tumour localization, verification of complete excision to prevent recurrence. This means that the surgery is less extent and with lower morbidity.

Integration of multiple skills in a multidisciplinary approach between surgery, nuclear medicine, endocrinology, radiology and pathologist has led to the development of a tailored procedure.

We promote further investigations of this approach to be inserted in the clinical management regarding not only neuroendocrine tumors but also thyroid cancer iodine negative with overexpression receptors for somatostatin.