I had my Thyroidectomy on Feb 5, 2008 for papillary CA, no thryroid meds in preparation for my RAI 131 treatment (150 mci) which was done last March 10, 2008. On March 17, 2008 a post theraphy WBS was done and here's the result:
Clinical Data: a 44 yo female status post thyroidectomy (feb 5, 2008) for Papillary CA. Referred for total radioiodine 131 body scanning to assess thyroid scan ablation and presence of distance metastasis.
Image obtaine in the anterior and posterior projections 7 days after an oral dose of 150 mci of iodine 131 show tracer uptake my residual thyroid parenchyma in the right and left thyroid beds with the following dimensions: 1.6cm x 1.5 cm (right thyroid fossa); 1.2 cm x 1.2 cm and 1.2 cm x 1.1 cm (left thyroid fossa)
Physiologic radioidine activity is seen in the oro/nasopharynx and paired saliva glands and transiting activity in the intestines and urinary bladder.
Focal tracer accumulation in the right supraclavicular area and hilar areas of the lungs
1. small thyroid gland residuals in the anterior cervical region, post- RAItherapy (150 mci on mar 10, 2008
2. distant functioning metastasis in the right supraclavicular area (lymph node 1.6cm x 1.5cm)
3. possible lung metastasis vs contamination
1. why is it those 2 smalldots in the lungs which the nuclear doctor says might be metastasis are so vague and hardly seen especially. Actually i cant hardly see 1 small dot on the anterior side and 2 dots on the posterior side of the scan. Were these really metastasis? On my presurgery thyroid ultrasound they didnt see the lymph node in the supraclavicular area can these be just a thyroid tissue or hardened tissue because of my scar sursegy. My chest Xray before surgery didnt show any lymph nodes also, so why these 2 small vague dots suddenly shows up in the scan?
2. The nuclear doctor recommended a repeat I-131 after 6 months? Chest Xray and TG ang TG antibodies. When should the Xray and tg be done? Will my Xray taken last feb 5, 2008 suffice?
3. What should I do? What do you recommend? Should I just wait for 6 months? Are there any other test to prove that there is really metastasis in my in my lungs and lymph node? I though RAI 131 150 mci would cure it together with surgery? Should I go another RAI Treatment? How many mci? I'm so worried? Am I going to die soon? I'm from the Philippines and we're not that advance in treating thyroid cancers. Pls help me