title: A rare case of asymptomatic radioiodine-avid renal and brain metastases 20 years after hemi-thyroidectomy for adenomatous goiter.
abstract: A 65-year-old patient, with a history of left hemi-thyroidectomy for adenomatous goiter 20 years previously, was found to have pulmonary lesions on chest X-ray, a brain lesion on computerized tomography (CT), and elevated serum thyroglobulin (Tg). While completion thyroidectomy revealed that no pathological evidence of thyroid malignancy, radioiodine-avid pulmonary, brain, and renal and bone lesions were identified on diagnostic as well as posttherapy whole body planar scintigraphy and single photon emission computed tomography-CT. Subsequent ultrasonography-guided biopsy of a renal nodule showed thyroid follicular cells. This case suggests that metastatic differentiated thyroid carcinoma should be suspected in asymptomatic patients with incidentally detected lesions, raised serum Tg, and history of thyroid lesions.
authors.affiliation: Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Sampath
authors.initials: S
authors.lastname: Santhosh
authors.affiliation: Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Anish
authors.initials: A
authors.lastname: Bhattacharya
authors.affiliation: Department of Otolaryngology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Roshan Kumar
authors.initials: RK
authors.lastname: Verma
authors.affiliation: Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Anupam
authors.initials: A
authors.lastname: Lal
authors.affiliation: Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Bhagwant Rai
authors.initials: BR
authors.lastname: Mittal
keywords: 131I; brain; hemimegalencephaly; metastasis; renal; single photon emission computed tomography-computed tomography; thyroid cancerhemihypoperfusion