Thyrotoxic periodic paralysis (TPP) is a condition featuring attacks of muscle weakness in the presence of hyperthyroidism. This study was conducted to know the incidence and method of prevention of thyrotoxic periodic paralysis in patients with

Papillary carcinoma thyroid is the most common type of thyroid cancer. Papillary thyroid cancer metastasizes commonly to regional lymph nodes, distant organ involvement is to lungs and bone are rare and is associated with poor prognosis. Metastases to intra-abdominal organs are extremely rare. Here, we report a case of 50-year-old female diagnosed with papillary microcarcinoma thyroid who initially treated total thyroidectomy, later presented with metastasis to liver, bone, left adrenal gland, and bilateral lungs. The functioning metastasis was diagnosed by Iodine-131 whole-body scan and later treated with radioiodine.

Background: Here, we present a retrospective study conducted from 2009 to 2018, which showed the presence of unilateral uptake of radioactive tracer on 99m Tc thyroid scintigraphy scan in 15 patients with Graves’ disease. Materials and Methods: All these patients had either clinical features of Graves’ disease or elevated thyroid hormone levels along with ultrasonographic features, showing either normal thyroid gland or diffuse thyroiditis. The scintigraphic features revealed increased uptake in one lobe of the thyroid gland with the other lobe being normal. Results: Of the 15 patients, 13 were females and two were males. The mean age of the patients was 47 years with standard deviation of 3.4 years (range 26–70 years). Eight of the 15 patients had increased uptake on the right lobe and seven had increased uptake in the left lobe. Conclusion: This study shows that there exists an entity called unilateral Graves’ disease which should be further evaluated.

Thyrotoxicosis can occur in the setting of differentiated thyroid cancer due to functioning metastases. Here, we report a case of a 63 year old woman with papillary carcinoma thyroid who underwent total thyroidectomy and defaulted for further scheduled treatment with high dose radioactive iodine therapy. 2 years after total thyroidectomy, she presented with signs and symptoms of thyrotoxicosis and a scalp swelling on the right side of frontal region. Excision biopsy revealed metastatic deposits of papillary carcinoma thyroid. Even after withdrawal of thyroxine, her serum thyrotropin did not rise and thyroglobulin levels were high, raising the suspicion of high volume tumour burden. I-131 whole body scan was done and it revealed radio iodine avid cervical lymph nodes along with functioning lung and skeletal metastases.

Objective: This prospective comparative study aimed to investigate the applied value of whole body 2deoxy-2[fluorine-18]fluoro-D-glucose positron emission tomography integrated with computed tomography ( 18 F-FDG PET/CT) in comparison to pelvic magnetic resonance imaging (MRI) in early cervical cancer patients.Material and methods: A prospective study was performed on 47 clinically early-stage cervical cancer patients evaluated with positron emission tomography/computed tomography (PET/CT) and MRI before surgery. The final postoperative histopathology report served as the reference standard. Both PET/CT and MRI images were analyzed and correlated with histopathologic findings concerning parametrial and lymph node involvement.Results: Sensitivity, specificity, and negative predictive value (NPV) of PET/CT were 33.3%, 81.8%, and 94.7%, respectively, for parametrium assessment. And the corresponding values of pelvic MRI were 33.3%, 63.6%, and 93.3%, respectively (PET/CT versus MRI, p > 0.05). The positive predictive value (PPV) of PET/CT (11.1%) was higher than MRI (5.9%) for parametrial assessment (p < 0.05). The sensitivity, specificity, PPV, and NPV of PET/CT were 75%, 83.7%, 30%, and 97.3%, respectively, for lymph node assessment. And the corresponding values of MRI were 75%, 81.3%, 27.3%, and 97.2%, respectively (PET/CT versus MRI, p > 0.05). There was no significant difference between MRI and PET/CT concerning stage migration (p = 0.4276). Conclusion:The PET/CT had no additional utility (compared to MRI) in the evaluation of local staging of clinically early cervical carcinoma patients.

99mTc-EC (Technetium-99m-ethylenedicysteine) is a renal tubular imaging agent introduced as an alternative to 99mTc-MAG3 (Technetium-99m-mercaptoacetyltriglycine) (1). This radiopharmaceutical can be easily labeled at room temperature and has high radiochemical purity and long stability for at least 8 h. Within 1 h 70% of 99mTc-EC is excreted in the urine (2). 99mTc-EC provides the same Scintigraphic information as 99mTc-MAG3. The Hepato biliary excretion of 99mTc-EC is very low and usually does not affect image interpretation on routine imaging, the possibility of visualization of the gall bladder should be kept in mind while reporting the 99mTc-EC renogram (1). We present a case of 99mTc-EC renogram, a suspected case of hypoplastic/ectopic right kidney, to look for ectopic kidney. In this case, there was unexpected visualization of gallbladder in delayed images. We herewith present this case, so that physician should be careful while reporting 99mTc-EC renogram, as there may be chances for gall bladder to be masquerading as Ectopic kidney.

Introduction:Breast cancer is the most common malignancy among women all over the world, which accounts to 25% of all cancers. In known cases of breast cancer, the risk of developing another denovo malignancy is more when compared to low risk groups, which might be due to common environmental risk factors, treatment induced risk factors, Genetic susceptibility for mutations, presence of cancer syndromes or better detection due to close surveillance.Objective:To study the profile of Metachronous 2nd primary malignancies suspected on 18F-FDG PET CT in known Breast cancer patients. In this Retrospective study from January 2014 to April 2018, all the consecutive patients with known Breast cancer, who were referred to Nuclear Medicine department for 18F- FDG PET CT for follow up evaluation were included. Suspected 2nd primary malignancies were correlated with Histopathological examination (HPE).Results:During the study period, a total of 233 Breast cancer patients (all are females), with a mean age of 54.2+13.4 years were studied. On 18F-FDG PET CT scan, suspicion for 2nd primary malignancy was observed in 37 patients. HPE was done in 28/37 patients at the site of suspected lesions. 15/28 were positive for second malignancy, and remaining 13/28 were either a benign pathology or a part of metastatic disease from the primary breast cancer. The sites of 2nd primary malignancies included Contralateral breast in 8/15 (53.3%), Ovary in 2/15 (13.3%), Endometrium in 2/15 (13.3%), Lung in 1/15 (6.6%), Stomach in 1/15 (6.6%) and Urinary bladder in 1/15 (6.6%) patients respectively. The incidence of metachronous 2nd primaries in breast cancer is 67.3 per 1000 breast cancer patients.Conclusion:Metachronous second primary cancers in breast cancer patients are not very rare. A high imaging suspicion on 18F-FDG PET CT helps in early detection of 2nd primary cancer, thereby facilitating early and appropriate management.

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