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January 28, 1974

Metastatic Thyroid Carcinoma

Author Affiliations

Indiana University School of Medicine Indianapolis

JAMA. 1974;227(4):439. doi:10.1001/jama.1974.03230170055022

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To the Editor.—  Just a short comment on the BRIEF REPORT entitled "Metastatic Thyroid Carcinoma" by Walter B. Shelley, MD, et al (226:173, 1973).As a practitioner of nuclear medicine, with a degree of experience in following such patients as are reported by Dr. Shelley, it is extremely discouraging to continue to see these patients worked up and followed so poorly. It is amazing that Dr. Shelley only suggests, in passing, that "possibly the131I photoscan would have showed these metastases." It has been our common experience in these cases that an adequate work-up is not performed to establish whether the thyroid metastases are, or are not, functional. Since a high proportion of thyroid metastases as reported by both Beierwaltes and Pochin are functional, they are thus amenable to the use of radioactive iodine ablation. For some reason, this latter fact is not well recognized. Thus, as in the