Abstract
A 25-year-old woman had total thyroidectomy and iodine-131 ablation therapy for papillary thyroid carcinoma. Whole body imaging on the 7th day of therapeutic activity demonstrated radioiodine uptake in the remnant tissue and intense heterogeneous uptake at the sacral region prominently in the posterior image. Initial interpretation was suspicious for sacral metastasis. Technetium-99m-methylene diphosphonate bone scan demonstrated normal bone uptake and the absence of left kidney. On blood-pool phase of bone scan, the absence of left renal activity and an extra area of uptake in the sacral region suggestive of pelvic kidney were noticed. Magnetic resonance imaging scan confirmed the ectopic pelvic kidney overlying the sacrum.
Highlights
Differentiated thyroid cancer is a possibly curable cancer that is associated with low mortality rates
It is usually managed by total thyroidectomy followed by iodine-131 (I-131) ablation of remnant thyroid tissue
Radioiodine has been used for decades for the diagnosis and treatment of patients with papillary or follicular thyroid carcinoma, and patients are mainly followed-up with whole-body I-131 scintigraphy (WBS) and thyroglobulin levels
Summary
Differentiated thyroid cancer is a possibly curable cancer that is associated with low mortality rates. It is usually managed by total thyroidectomy followed by iodine-131 (I-131) ablation of remnant thyroid tissue. 1-3% of patients may have distant metastases at initial diagnosis, and another 7-23% may develop distant metastases during disease course. The distant metastases, bone metastases, increase mortality rate and decrease quality of life. Radioiodine has been used for decades for the diagnosis and treatment of patients with papillary or follicular thyroid carcinoma, and patients are mainly followed-up with whole-body I-131 scintigraphy (WBS) and thyroglobulin levels.
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