PMID- 21272685
OWN - NLM
STAT- MEDLINE
DCOM- 20110715
LR  - 20220311
IS  - 1558-4623 (Electronic)
IS  - 0001-2998 (Linking)
VI  - 41
IP  - 2
DP  - 2011 Mar
TI  - The problem of the patient with thyroglobulin elevation but negative iodine 
      scintigraphy: the TENIS syndrome.
PG  - 113-20
LID - 10.1053/j.semnuclmed.2010.10.002 [doi]
AB  - The available data upon which to act in caring for patients with functioning 
      thyroid cancer and thyroglobulin elevation/negative iodine scintigraphy (TENIS) 
      are imperfect, almost never coming from randomized, blinded studies. When the 
      serum thyroglobulin exceeds 2-10 ng/mL, one should use the latest imaging 
      equipment available to find metastatic disease, especially in areas in which it 
      is potentially resectable, ie, neck, bone, and occasionally brain, and 
      collaborate with an experienced surgeon in removing such metastases. If one 
      cannot locate operable metastases and/or tumor location remains elusive, empiric 
      high-dose (131)I therapy, preceded by dosimetry, should be considered. There are 
      no randomized studies to prove that this treatment prolongs life, although there 
      is definite evidence of cell killing, because the serum thyroglobulin level 
      frequently diminishes after radioiodine therapy. In selected cases External beam 
      radiotherapy will be helpful when the tumor has been located but cannot be fully 
      removed, for example, with invasion of the trachea, spine, or muscles. There are 
      several tyrosine kinase inhibitors that have shown some effectiveness against the 
      TENIS syndrome, but these should ideally be used in the context of a clinical 
      trial. Tyrosine kinase inhibitor drugs should be preferred to conventional 
      chemotherapy at this time; data on lenalidominde have only appeared in abstract 
      form. The return of NIS function, to permit functioning thyroid cancer with the 
      TENIS syndrome to again concentrate therapeutic amounts of (131)I, remains an 
      elusive goal, with few drugs showing real promise. Gene therapy to restore the 
      function of the NIS gene and enhance cellular immunomodulatory and tumor 
      suppressive activity has not yet succeeded clinically. Physicians caring for 
      patients with the TENIS syndrome are urged to enter them into clinical 
      therapeutic studies whenever possible.
CI  - Copyright (c) 2011 Elsevier Inc. All rights reserved.
FAU - Silberstein, Edward B
AU  - Silberstein EB
AD  - The Division of Nuclear Medicine, Department of Radiology, UC Health University 
      Hospital, Cincinnati, OH, USA. silbereb@healthall.com
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Semin Nucl Med
JT  - Seminars in nuclear medicine
JID - 1264464
RN  - 0 (Iodine Radioisotopes)
RN  - 9002-71-5 (Thyrotropin)
RN  - 9010-34-8 (Thyroglobulin)
SB  - IM
MH  - Humans
MH  - Iodine Radioisotopes
MH  - Radiation Dosage
MH  - Radionuclide Imaging/*methods
MH  - Thyroglobulin/blood/*metabolism
MH  - Thyroid Neoplasms/blood/diagnostic imaging/metabolism
MH  - Thyrotropin/metabolism
EDAT- 2011/01/29 06:00
MHDA- 2011/07/16 06:00
CRDT- 2011/01/29 06:00
PHST- 2011/01/29 06:00 [entrez]
PHST- 2011/01/29 06:00 [pubmed]
PHST- 2011/07/16 06:00 [medline]
AID - S0001-2998(10)00134-0 [pii]
AID - 10.1053/j.semnuclmed.2010.10.002 [doi]
PST - ppublish
SO  - Semin Nucl Med. 2011 Mar;41(2):113-20. doi: 10.1053/j.semnuclmed.2010.10.002.