PEI in Thyroid Cancer Recurrence

Thyroid Cancer Conference:

Case: Patient with stable thyroid cancer disease with detectable Tg and Tg-Ab with previous history of thyroidectomy present with neck pain. TSH was 33 and Tg 30. CT evaluation and ultrasound show residual thyroid tissue. With TSH suppression, the Tg dropped to a low level again. The Tg-ab had been stable throughout without any rise.

Question of the options:
1. is this recurrence?
2. options: RAI, thyroid surgery, just followup, or PEI.

Dangers of PEI
1. nerve damage. The laryngeal nerve is very delicate. alcohol can cause permanent damage to this nerve.
2. A large amount of alcohol is needed to treat a large lesion
3. Not currative.

In terms of recurrence, Tg-ab may be a better marker of disease than Tg in this case?

On CT, the thyroid tissue will light up like bone.