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Spontaneous Regression Of Metastatic Papillary Thyroid Cancer In A Lymph Node

Shim et al., 2018Thyroid cancer

Shim, J., Rao, J., & Yu, R. (2018). spontaneous Regression of Metastatic Papillary thyroid Cancer in a Lymph Node. Case reports in endocrinology, 2018, 5873897. https://doi.org/10.1155/2018/5873897

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Abstract

Spontaneous regression of cancer is defined as disappearance of cancer in the absence of specific therapy. In thyroid cancer patients with biochemically incomplete response to initial treatments, spontaneous decline in thyroglobulin levels without any cancer treatment is a well-known phenomenon; however, spontaneous regression of persistent or recurrent structural disease has not been reported. We here present a case of papillary thyroid cancer in a 58-year-old female who underwent total thyroidectomy and two radioiodine ablations. She had persistently elevated thyroglobulin levels. Six years after her initial treatments, she had biopsy-proven cervical lymph node metastasis. The patient opted not to undergo any further treatment. Over the course of the next 10 years, without any additional treatment, the lymph node disappeared and her thyroglobulin levels decreased to almost undetectable ranges, implying near-complete regression. Our case illustrates that metastatic papillary thyroid cancer in lymph nodes can regress spontaneously.

Case Details

Disease Location

Left neck submandibular lymph node metastasis (primary papillary thyroid ca)

Personal Characteristics

58-year-old female with dm2, history of papillary thyroid carcinoma treated with thyroidectomy and radioiodide therapy. Patient maintained on levothyroxine post thyroidectomy.

Clinical Characteristics

6 years after primary cancer diagnosis and treatment (or 2 years after last radioiodine treatment), found to have lymphadenopathy and biopsy confirmed metastatic papillary thyroid ca. Patient refused any further treatment and was on follow up. 1 years later, spotaneous regression noted on us. At 6, 9 years post metastasis dx - continues to be negative including negative tg levels.

Remission Characteristics

Spotaneous regression of metastatic lesion 1 year post diagnosis of metastasis. Tg levels also gradaully normalized. Remains in regression at 6,9 years post diagnosis of metastasis.

Treatment & Mechanisms

Clinical Treatment

Radioactive iodine ablation