Management of Differentiated Thyroid Cancer Patients with Elevated Serum Thyroglobulin Level but Negative Radioiodine Scan

After undergoing the initial therapy for differentiated thyroid cancer of surgery and radioiodine, a patient is considered in remission when a follow-up radioiodine scan is negative, serum thyroglobulin is undetectable and there is no clinical or radiological evidence of the disease. However, cases with elevated serum thyroglobulin, but negative radioiodine scan are occasionally seen. Management of these patients is controversial, particularly the role of alternative radionuclear imaging studies, empiric radioiodine therapy and other treatment options.