Un caso de carcinoma de tiroides de células de Hürthle. Abordando la incertidumbre del papel del Yodo I-131

Abstract

Objetive: The objective is to present a case with successful I-131 uptake in a patient with Hürthle cell carcinoma. Case presentation: A 60 years old female patient with diagnosed goiter, that was treated with thyroid hormone analogues that didn’t decreased the growth of the mass; due to that, it was biopsied. The report of the pathology reported a Hürthle cell neoplasm with indeterminate behavior, lately oncologic thyroidectomy and lymphadenectomy were performed, from which the pathology plates were revised showing a definitive diagnosis of Hurthle cell carcinoma. The case was reviewed in a medical board where I-131 therapy was suggested. In the postheraphy scan performed, there was evidence of I-131 uptake in the neck and in an adenopathy. Twelve months later, there was evidence of pulmonary relapse. Is an uncertainty to know if the patient in this case would have been able to benefit from an early ablative therapy with I-131 decreasing the risk of relapse after having documented tumor avidity for it. The Hürthle thyroid carcinoma is rare, and its natural history is still controversial because it’s challenging diagnosis, treatment and monitoring. Because there is no definitive agree about his integral approach despite it has been considered differentiated thyroid cancer even therapy with I-131 is still debated.