Nucl Med Mol Imaging.  2017 Sep;51(3):256-260. 10.1007/s13139-016-0462-5.

Bilateral Renal Metastasis of Hürthle Cell Thyroid Cancer with Discordant Uptake Between I-131 Sodium Iodide and F-18 FDG

• Claimon A
• Suh M
• Cheon GJ
• Lee DS
• Kim EE
• Chung JK

• KMID: 2396585
• DOI: http://doi.org/10.1007/s13139-016-0462-5

Abstract

Renal metastasis of thyroid cancer is extremely rare. We report the case of a 62-year-old woman with Hürthle cell thyroid cancer (HCTC) with lungs, bones, and bilateral kidneys metastases. The renal metastatic lesions were clearly demonstrated by ¹³¹I whole body scan (WBS) with SPECT/CT. However, they exhibited false-negative results in ¹â¸F-FDG PET/CT, kidney ultrasonography, and contrast-enhanced CT scan. The findings imply that tumors have low glucose metabolism and are able to accumulate radioiodine, which is not commonly found in the relatively aggressive nature of HCTC. The patient received two sessions of 200 mCi ¹³¹I therapy within 6 months duration. There was complete treatment response as evaluated by the second post-therapeutic ¹³¹I SPECT/CT and serum thyroglobulin. To our knowledge, renal metastasis from HCTC with positive ¹³¹I but negative ¹â¸F-FDGuptake has not been reported in the literature. This case suggests that ¹³¹I SPECT/CTis useful for lesion localization and prediction of ¹³¹I therapy response.

Keyword

F-18 FDGPET/CT; Hürthle cell thyroid cancer; I-131 whole-body scan; Renalmetastasis; Discordant uptake

MeSH Terms

Female
Glucose
Humans
Kidney
Lung
Metabolism
Middle Aged
Neoplasm Metastasis*
Positron-Emission Tomography and Computed Tomography
Sodium Iodide*
Sodium*
Thyroglobulin
Thyroid Gland*
Thyroid Neoplasms*
Tomography, X-Ray Computed
Ultrasonography
Whole Body Imaging
Glucose
Sodium
Sodium Iodide
Thyroglobulin