A 26-year-old woman with pulmonary metastasis of thyroid cancer underwent a total thyroidectomy and cervical lymph node dissection followed by 2 courses of 131 I therapy. The posttherapeutic whole-body scan after the second dose of 131 I therapy showed diffuse tracer uptake in both lungs. Besides this, there is a local abnormal radiotracer uptake in the left axillary region. SPECT/CT images localized this abnormal radioactivity in a subcutaneous, oval-shaped, approximately 2.2-cm slightly hyperdense lesion, which was pathologically confirmed as an epidermal cyst.
A 64-year-old woman with metastatic papillary thyroid cancer underwent a total thyroidectomy followed by 2 courses of 131I therapy. The posttherapeutic whole-body scan after the second dose of 131I therapy showed multifocal bone metastasis. In addition, there is focal abnormal intense radiotracer uptake at the right inguinal region. SPECT/CT revealed that this abnormal focal radioactivity was from a superficial skin lesion. Further physical examination revealed a raised, approximately 1-cm, irregular grayish-brown lesion on the right groin skin. Histopathological examination confirmed the diagnosis of basal cell papilloma (seborrheic keratosis).
It is unusual to observe 131 I accumulation in the gallbladder and high-grade serous ovarian adenocarcinoma during posttherapeutic 131 I scan. We report the case of a 55-year-old woman with papillary thyroid cancer, who received total thyroidectomy and then 3 courses of 131 I therapy. The posttherapeutic whole-body scan after the third dose of 131 I therapy revealed abnormal 131 I uptake in the right upper abdomen, overlapping the liver, and the pelvis. Further SPECT/CT imaging found that they were from an enlarged gallbladder and a large pelvic complex solid and cystic mass, which was pathologically confirmed as bilateral high-grade serous ovarian adenocarcinoma.
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