Papillary Thyroid Carcinoma: Four Cases Required Caution during Long-Term Follow-Up
A 67-year-old female patient received total thyroidectomy due to PTC. Metastases of the carcinoma in the neck lymph node were found, and the patient underwent lymph node dissection in the neck area as a secondary procedure (). After all procedures were completed, she received high-dose RAI therapy. While conducting a 2-year follow-up, lung nodules were found, and we conducted additional high-dose RAI therapy. A post-RAI follow-up chest CT was conducted, but revealed an increase in the number and size of nodules (). RAI ablation (200 mCi) was performed again due to refractory disease. The patient complained of pain in thoracic wall and dyspnea after 6 months, and chest CT findings showed a large amount of pleural fluid on the right side, as well as metastatic lymph nodes (). We performed a pleural biopsy in addition to pleural fluid drainage and pleurodesis (). Nevertheless, the amount of pleural fluid continued to increase and dyspnea was aggravated. Consequently, the condition of the patient deteriorated and the disease remained refractory to treatment, so we maintained only conservative treatment. The patient died 3 months after pleural fluid was first observed.