engleski

Problems with the treatment of papillary thyroid carcinoma in dialysis patients

We present 5 dialysis patients with papillary thyroid carcinoma, accidentally detected by a sonographic neck examination made because of secondary hyperparathyroidism. There are 3 women and 2 men, aged 30-57 years at the time of diagnosis, treated with haemodialyses 0-10 years. In two patients occult thyroid carcinoma up to 5 mm were found. They were treated surgically and with suppressive therapy. The next patient had multicentric papillary carcinoma and carcinoma of the parathyroid gland. She was also treated surgically and with suppressive therapy. She died after 3 years due to brain metastases. In two other patients metastatic papillary carcinoma were detected. Total thyreoidectomia with lateral neck dissection were performed. One patient has been free of illness for 8 years, with only suppressive therapy. Thee last patient suspected of having lymphnode metastases on the contralateral side. There are problems with TSH suppression. Radioiodine therapy was not performied because of previous administration of taking amiodarone and blocked accumulation. None of our patients were treated with radioiodine therapy for different reasons. It is questionable if they need a special individualised treatment, or, if they must be treated as usual, with only modified doses.

papillary thyroid carcinoma; hemodialysis; radioiodine therapy

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