Nasolacrimal duct obstruction associated with radioactive iodine therapy for thyroid carcinoma.
Nasolacrimal duct obstruction associated with radioactive iodine therapy for thyroid carcinoma.
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与放射性碘治疗甲状腺癌相关的鼻泪管阻塞。
DOI：
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发表时间：
2003
影响因子：
2
通讯作者：
B. Esmaeli
中科院分区：
文献类型：
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作者：
T. Shepler;S. Sherman;M. Faustina;N. Busaidy;M. Ahmadi;B. Esmaeli
一名 50 岁女性因甲状腺癌 131I 治疗后不久出现 5 年单侧溢泪病史。最近的重组人促甲状腺激素（Thyrogen）扫描显示右眼附近有一个摄取灶，最初被认为可能是转移灶。探诊和冲洗显示右侧鼻泪管完全堵塞。患者接受了右侧泪囊鼻腔吻合术 (DCR) 和泪囊活检。泪囊和鼻粘膜的组织病理学检查显示异物反应和纤维化，未见恶性细胞。 DCR 后重复的甲状腺素扫描显示鼻子或泪囊附近没有残留的活动焦点，并证实右侧泪道重新建立。该病例表明甲状腺癌的 131I 治疗可能与鼻泪管阻塞有关。有甲状腺癌病史的患者在甲状腺素扫描中出现泪囊附近的摄取灶可能并非由于新的转移灶，而可能确实是由于鼻泪管堵塞导致 131I 在泪囊中聚集所致。
A 50-year-old woman presented with a 5-year history of unilateral epiphora that began shortly after 131I therapy for thyroid carcinoma. A recent recombinant human thyroid-stimulating hormone (Thyrogen) scan had shown a focus of uptake adjacent to the right eye that was initially thought to be a possible metastasis. Probing and irrigation revealed complete blockage of the right nasolacrimal duct. The patient underwent a right dacryocystorhinostomy (DCR) and biopsy of the lacrimal sac. Histopathologic examination of the lacrimal sac and nasal mucosa revealed foreign-body reaction and fibrosis with no malignant cells. A repeat Thyrogen scan after DCR showed no residual focus of activity in the nose or near the lacrimal sac and confirmed reestablishment of lacrimal drainage on the right side. This case demonstrates that 131I therapy for thyroid carcinoma can be associated with nasolacrimal duct obstruction. The appearance of a focus of uptake near the lacrimal sac on Thyrogen scanning in a patient with a history of thyroid carcinoma may not be due to a new focus of metastasis and may indeed be due to pooling of 131I in the lacrimal sac due to nasolacrimal duct blockage.