Abstract
A patient with widely metastatic differentiated thyroid cancer who had been heavily pretreated with 131I was given recombinant human thyroid stimulating hormone (rhTSH) prior to 131I treatment. Clinical and physical data from both this case and the literature suggest that the recombinant hormone, not the 131I, may have caused a significant portion of the tumor swelling, which in turn was the most likely cause of the patient's symptoms. The potential effect of 131I-induced tumor swelling and direct radiation effect on the lung is also analyzed. We review the potential hazards associated with rhTSH in patients with metastasis and propose means of minimizing this risk.
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