case_images: PMC5533473_01
case_images: (A) The time course in years of the patient's illness, with stimulated thyroglobulin levels (-- --), unstimulated thyroglobulin levels (-- --), radioactive iodine therapy doses (RAI, 5.5 GBq each dose), I131 scan intervals and results (+ indicating tracer uptake and N no tracer uptake), and timing and duration of examestane, everolimus, and sorafenib. (B) The bone scan performed at 57 years, demonstrating metastatic bone disease with increased tracer uptake in the sternum, right 5th and 6th ribs, left scapula, right anterior superior iliac spine and intertrochanteric region of proximal left femur.
case_images: tcrm-13-915Fig1.jpg
case_images: PMC5533473_01_tcrm-13-915Fig1.jpg
case_images: f1-tcrm-13-915
case_images: Progressive radioactive iodine doses and scans and the stimulated and unstimulated thyroglobulin levels are shown in Figure 1A. Thyroglobulin declined (Figure 1A). Unstimulated thyroglobulin levels rose (Figure 1A). Progressive widespread metastatic disease was evident (Figure 1B). As some of the metastatic burden was thyroid cancer related, 5.6 GBq I131 was administered; the unstimulated thyroglobulin level after 4 weeks was 221 microg/L (Figure 1A).