Use of recombinant human thyrotropin in a complicated case of metastatic papillary thyroid carcinoma.

Objective: To describe a complicated case of metastatic papillary thyroid carcinoma and the use of recombinant human thyrotropin (thyroid-stimulating hormone) (rhTSH) in conjunction with treatment with radioactive iodine (131I). Methods: We present a detailed case report and discuss the use of rhTSH in this setting. Results: A 62-year-old Filipino man with a history of incompletely treated papillary thyroid cancer sought medical assistance in the emergency department because of weakness of the right upper extremity. Imaging studies showed a large mediastinal mass in association with C7 vertebral body erosion and spinal cord impingement. A cervical lymph node biopsy revealed papillary thyroid carcinoma, follicular variant. Further imaging studies disclosed widely metastatic disease. The patient subsequently had a complicated treatment course and received rhTSH in conjunction with 131I treatment. Conclusion: This unusual case demonstrates possible complications of metastatic papillary thyroid carcinoma alon...