Santhosh Sampath, Bhattacharya Anish, Verma Roshan Kumar, Lal Anupam, Mittal Bhagwant Rai
Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Otolaryngology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Nucl Med. 2016 Jan-Mar;31(1):42-4. doi: 10.4103/0972-3919.172358.
A 65-year-old patient, with a history of left hemi-thyroidectomy for adenomatous goiter 20 years previously, was found to have pulmonary lesions on chest X-ray, a brain lesion on computerized tomography (CT), and elevated serum thyroglobulin (Tg). While completion thyroidectomy revealed that no pathological evidence of thyroid malignancy, radioiodine-avid pulmonary, brain, and renal and bone lesions were identified on diagnostic as well as posttherapy whole body planar scintigraphy and single photon emission computed tomography-CT. Subsequent ultrasonography-guided biopsy of a renal nodule showed thyroid follicular cells. This case suggests that metastatic differentiated thyroid carcinoma should be suspected in asymptomatic patients with incidentally detected lesions, raised serum Tg, and history of thyroid lesions.
一名65岁患者，20年前因腺瘤性甲状腺肿接受左侧甲状腺次全切除术，胸部X线检查发现肺部病变，计算机断层扫描（CT）发现脑部病变，血清甲状腺球蛋白（Tg）升高。虽然甲状腺全切术后未发现甲状腺恶性肿瘤的病理证据，但在诊断性及治疗后全身平面闪烁扫描和单光子发射计算机断层扫描-CT上发现了摄取放射性碘的肺部、脑部、肾脏和骨骼病变。随后对一个肾结节进行超声引导下活检，显示为甲状腺滤泡细胞。该病例表明，对于偶然发现病变、血清Tg升高且有甲状腺病变史的无症状患者，应怀疑有分化型甲状腺癌转移。
