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Redifferentiation Therapy with Retinoic Acid in Follicular Thyroid Cancer

Departments of Nuclear Medicine and Pathology, University of Bonn, Bonn, Germany

Correspondence: For correspondence or reprints contact: Frank Grüwald, MD, Department of Nuclear Medicine, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany.

ABSTRACT

We report on a patient with a follicular Hürthle cell carcinoma in whom distant metastases were initially radioiodine negative or only weakly positive. Redifferentiation therapy with 13-cis retinoic acid induced a significant radioiodine uptake in metastatic tissue. Thyroglobulin (Tg) immunostaining and autoradiography of a bone metastasis in the right femur, which was initially radioiodine negative, proved Tg synthesis, combined with iodine incorporation into tumor cells. Glucose metabolism in metastases was partially increased and partially unchanged after redifferentiation therapy. The distinct increase of serum Tg after retinoic acid treatment was interpreted as a functional sign of redifferentiation.

Key Words: thyroglobulin • thyroid cancer • redifferentiation therapy • retinoic acid • PET

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