We present a 75-year-old-man affected by chronic renal failure in whom metastases from differentiated thyroid cancer (DTC) were incidentally discovered at 99mTcO4 neck-thorax scan in the setting of a diagnosis of secondary hyperparathyroidism. Ten years before, he had undergone near-total thyroidectomy for a multinodular goiter. Result of the pathological examination was negative for DTC. At our observation, serum thyroglobulin was high in the absence of Tg-Ab, consistent with metastatic disease. Neck ultrasonographynography was negative. The patient underwent 131I therapy (3700 MBq) after stimulation with recombinant human thyroid-stimulating hormone. Postdose whole-body scan confirmed the metastases already demonstrated by 99mTcO4.
From the *Department of Radiological Sciences, Nuclear Medicine Unit, †Department of Clinical and Experimental Medicine and Pharmacology, Section of Endocrinology, and ‡Unit of Nephrology and Dialysis, University of Messina, Messina, Italy.
Received for publication December 10, 2011; revision accepted March 6, 2012.
Conflicts of interest and sources of funding: none declared.
Reprints: Alfredo Campennì, MD, Unità di Medicina Nucleare, Dipartimento di Scienze Radiologiche, Padiglione E, piano terra, Policlinico Universitario “G. Martino,” v. Consolare Valeria, 98125 Messina, Italy. E-mail: email@example.com.