title: Symptomatic calcification of a thyroid lobe and surrounding tissue after radioactive iodine treatment to ablate the lobe.
abstract: BACKGROUND
  Fine-needle aspiration diagnosis of follicular carcinoma presents a dilemma because malignancy is confirmed when vascular or capsular invasion is present. Completion thyroidectomy may be necessary when the diagnosis of follicular carcinoma is made following hemithyroidectomy. Ablation of the remaining lobe with radioactive iodine has been used as an alternative to completion thyroidectomy. Here we report an unusual apparent complication of this treatment.
  
  
  METHODS
  A 51-year-old woman presented in September 24, 2009 with a stony, hard calcification of left thyroid gland. She complained of recent progressive hoarsening of her voice. Her medical history was positive for a subtotal thyroidectomy on September 6, 1993. Histologic analysis identified follicular carcinoma. Two months postoperatively, the remaining tissue was ablated with (131)I (150 mCi) as an alternative to completion thyroidectomy. We performed computed tomography of the neck, which demonstrated 1.6  x 1.9 x  2.2 cm dense speculated calcification of the entire left residual thyroid gland. The calcification infiltrated the trachea wall. Completion thyroidectomy, including resection of the calcification, was performed. Histologic examination revealed dystrophic calcification.
  
  
  CONCLUSIONS
  We report an unusual replacement of the thyroid remnant with calcification that developed over a period of 16 years following radioactive iodine lobe ablation as an alternative to completion thyroidectomy for thyroid follicular carcinoma. To our knowledge, this is the first such case in the English language literature.
authors.affiliation: Department of Internal Medicine, Chosun University Hospital, Gwangju, Republic of Korea.
authors.forename: Jin Hwa
authors.initials: JH
authors.lastname: Kim
authors.forename: Jun Hee
authors.initials: JH
authors.lastname: Park
authors.forename: Sang Yong
authors.initials: SY
authors.lastname: Kim
authors.forename: Hak Yeon
authors.initials: HY
authors.lastname: Bae
mesh_terms: D055011:Ablation Techniques / Q000009:adverse effects; D018263:Adenocarcinoma, Follicular; D002114:Calcinosis / Q000209:etiology*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D011878:Radiotherapy / Q000009:adverse effects; D013959:Thyroid Diseases / Q000209:etiology*; D013961:Thyroid Gland / Q000473:pathology* / Q000528:radiation effects; D013964:Thyroid Neoplasms / Q000532:radiotherapy / Q000601:surgery; D013965:Thyroidectomy; D016896:Treatment Outcome
chemical_list: D007457:Iodine Radioisotopes