Symptomatic Calcification of a Thyroid Lobe and Surrounding Tissue After Radioactive Iodine Treatment to Ablate the Lobe

Abstract

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.

A solitary hyperfunctioning thyroid nodule harboring thyroid carcinoma: review of the literature

“…Given the estimated 3.1% prevalence of malignancy within hot nodules, and also taking into account the difficulty in predicting whether a particular hot nodule is malignant, we recommend that hot nodules that are not treated surgically (as is an option to manage the hyperthyroidism) be considered for biopsy if high-risk historical and/or suspicious sonographic features are present or if these nodules grow over time, just as is currently recommended for nodules that are not hyperfunctioning [6]. This should also include previously hyperfunctioning nodules treated with radioiodine, although the known occurrence of dystrophic calcification and cystic degeneration as sequelae of radioiodine ablation should be taken into account when assessing their sonographic features [86]. Future prospective studies could help determine if biopsying at the time of diagnosis all hot nodules with suspicious sonographic characteristics and/or associated high-risk historical features versus biopsying hot nodules only if the initial sonographic characteristics worsen over time would result in better outcomes.…”

Nondestructive recognition and differentiation of quasi‐spherical structures of biologic interest

“…While these are not the only masses, structures with incomplete surface calcification are beyond the scope of this review. Calcified hydatid ( Echinococcus ) cysts (Hosch et al, 2007), leiomyoma (Wilde & Scott‐Barrett, 2009), uterine fibroids, thyroid nodules (Kim et al, 2011; Miller et al, 2020), pulmonary nodules (Erasmus et al, 2000; O'Donovan, 1997), adenomas (Pyram et al, 2011) and renal masses (Weyman et al, 1982) are unlikely to be confused with the phenomena discussed above. The appearance of a thyroid nodule (Natural History Museum Vienna MN272) is irregular, grooved with its external surface and radiologic appearance quite similar to that of dystrophic calcification, similar to that seen with leiomyomas (Komolafe, 1981; Kwee & Kwee, 2019).…”

Bilateral Vocal Fold Paralysis Secondary to Intrathyroidal Calcifications Following Remote Administration of Radioactive Iodine Therapy for Graves Disease

“…1 Other uncommon etiologies include a large intrathyroidal calcification resulting from radioactive iodine ablation (RAI). 2 Unilateral VFP can result in hoarseness and dysphagia, while bilateral VFP can result in respiratory distress due to narrowing of the airway at the glottis. 1 We report a 60-year-old patient presenting with progressive stridor and flexible laryngoscopy revealed immobility of the true vocal folds bilaterally.…”

“…[3][4][5][6][7][8] However, intrathyroidal calcifications as a result of RAI have been reported only once before. 2 In that case, RAI was used for ablation of a left thyroid lobe as an alternative to completion thyroidectomy following diagnosis of follicular carcinoma after a right hemithyroidectomy. 2 Preoperative ultrasound confirmed a normal left thyroid lobe.…”

“…2 In that case, RAI was used for ablation of a left thyroid lobe as an alternative to completion thyroidectomy following diagnosis of follicular carcinoma after a right hemithyroidectomy. 2 Preoperative ultrasound confirmed a normal left thyroid lobe. Several years later, the patient developed progressive hoarseness associated with left thyroid lobe calcification, which resolved after removal.…”