Management and challenges of thyroid cancer treatment with radioiodine therapy in a patient with cerebral palsy and autism spectrum disorder: a case report

Background: Thyroid cancer is one of the most prevalent endocrine neoplasms in Brazil, and radioiodine therapy (RAI) is a well-established adjuvant treatment. However, managing RAI can be particularly challenging in patients with neurological disorders and significant behavioral disturbances. Case Presentation: We report the case of a 16-year-old adolescent with cerebral palsy and level 3 autism spectrum disorder (ASD) who underwent RAI after total thyroidectomy for metastatic papillary thyroid carcinoma. The case illustrates the tailored technical and clinical strategies implemented by the multidisciplinary team to address the patient’s complex needs, including adaptations in radiation protection, hospitalization logistics, and caregiver support. Conclusion / Lessons Learned: This case underscores the complexity of performing RAI in patients with severe neurological and behavioral impairments. It reinforces the importance of early and expanded multidisciplinary involvement—particularly from neurology and psychiatry—during the preparatory phase. Additionally, enhanced caregiver training and consideration of alternative therapeutic strategies are essential to ensure safety, optimize radiological protection, and improve adherence throughout the treatment process.