World Journal of Endocrine Surgery

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VOLUME 8 , ISSUE 2 ( May-August, 2016 ) > List of Articles


Dilemmas in Metastatic Differentiated Thyroid Cancer: To irradiate, medicate, or palliate?

Melissa H Lee, Jayne E Moxey, Sue-Anne McLachlan, Richard J MacIsaac, Nirupa Sachithanandan

Citation Information : Lee MH, Moxey JE, McLachlan S, MacIsaac RJ, Sachithanandan N. Dilemmas in Metastatic Differentiated Thyroid Cancer: To irradiate, medicate, or palliate?. World J Endoc Surg 2016; 8 (2):168-171.

DOI: 10.5005/jp-journals-10002-1184

Published Online: 01-04-2009

Copyright Statement:  Copyright © 2016; The Author(s).



To explore the challenges in the management of metastatic differentiated thyroid cancer.


Differentiated thyroid cancer (DTC) is the most common form of thyroid cancer. The initial diagnosis of thyroid carcinoma and the distinction between benign and neoplastic disease can be challenging. Radioiodine-refractory metastatic DTC also presents a therapeutic dilemma. Novel targeted agents for advanced radioiodine-refractory metastatic thyroid cancer, such as tyrosine kinase inhibitors (TKIs), are being increasingly used with clinical success, broadening current available therapeutic options.

Case report

We present the case of a 61-year-old woman with radioiodine-refractory metastatic follicular thyroid carcinoma, which was initially misdiagnosed as benign Hurthle cell adenoma. We focus on the challenges in both the initial diagnosis and the subsequent management of her advanced disease with skeletal dominant metastases.


The advent of targeted systemic therapies as emerging frontline and salvage therapy is a novel addition to the management of radioiodine-refractory advanced DTC. Further studies to expand the role of sequential and redifferentiation therapy for advanced disease and strategies to reduce skeletalrelated events are still required.

How to cite this article

Lee MH, Moxey JE, McLachlan S-A, MacIsaac RJ, Sachithanandan N. Dilemmas in Metastatic Differentiated Thyroid Cancer: To irradiate, medicate, or palliate? World J Endoc Surg 2016;8(2):168-171.

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