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Nasolacrimal duct obstruction (NLDO) is a rare complication after radioiodine therapy and may cause false positive 131I uptake at the point of obstruction in 131I whole body scan. Here, we report a 59-year-old female patient with papillary thyroid cancer treated with total thyroidectomy followed by 131I therapy. 131I whole body scan revealed focal uptake in the head. Single photon emission computed tomography/computed tomography (CT) showed focal uptake at the right proximal nasolacrimal duct. The ophthalmologic examination and the diagnostic maxillofacial CT confirmed the diagnosis of NLDO. [ABSTRACT FROM AUTHOR]

Objective: Remnant ablation with radioactive iodine (I-131) is a successful form of treatment that aims to destroy the remaining residual tissue and/or metastatic tissue after total thyroidectomy in differentiated thyroid cancer (DTC) patients. High level of thyroid stimulating hormone (TSH) (≥30 mIU/L) is recommended for success of ablation treatment. In this retrospective study, our aim was to investigate whether the TSH levels at the time of ablation effect the success of radioactive iodine remnant ablation. Methods: Patients who were diagnosed with DTC, treated with bilateral total/near total thyroidectomy and who were referred for I-131 remnant ablation were included in this study. Patients with undetectable TSH-stimulated serum thyroglobulin (Tg) level, normal physical examination, negative results on whole body scan with I-131, and no evidence of neck lymph node metastasis on ultrasound were defined as disease-free. The correlation between TSH level at the time of ablation and ablation success was assessed. Results: Two hundred sixty one consecutive patients were included in the present study. Mean TSH level was 19.47±6mIU/L in the 34 patients with TSH <30 mIU/L, while mean TSH level was 73.65±27 mIU/L in the 227 patients with TSH ≥30 mIU/L during I-131 remnant ablation. Ablation was unsuccessful in only one patient with TSH <30 mIU/L who had lung metastasis. Ablation was unsuccessful in 5.1% of patients with TSH ≥30 mIU/L. The effect of TSH level was not significant on ablation success (p=0.472). Conclusion: In conclusion, we think that a high TSH serum level alone is not a factor for the success of ablation. Age, presence of metastasis, extent of residual thyroid mass should also be considered. Especially, in the presence of metastatic tissue, obtaining adequate increase in TSH level is not always possible. The success of ablation at lower levels of TSH elevations may be sufficient for patients, and long-term hypothyroidism may not be required. [ABSTRACT FROM AUTHOR]

In this article, we report a 51 years old female patient treated with radioactive iodine (RAI-131I) treatment for thyroid papillary carcinoma and developing parotitis on the 24 hour following treatment. Siaload enitis after high dose ablative therapy with 131I is a relatively common complication with a low clinical impression. Taste alteration or loss, and nausea and vomiting due to radiation sickness are the other most frequent side effects. Xerostomia is an important problem increasing morbidity of the patients. For this reason, it is important to prevent xerostamia by following serum amylase levels in symptomatic patients. By taking into account that not only bacterial and viral factors but also radiation may cause sialoadenitis, one has to rule out other parotisis possibilities by clinical and laboratory findings before claiming that salivary gland enlargement developing after radioiodine is a complication of radiation. Moreover, history of RAI treatment should be given importance in patients applying either to emergency services or to Ear Nose Throat and Infectious Diseases Department with dry mouth. [ABSTRACT FROM AUTHOR]