Claimon Apichaya, Suh Minseok, Cheon Gi Jeong, Lee Dong Soo, Kim E Edmund, Chung June-Key
Department of Nuclear Medicine, Seoul National University Hospital, 101 Daehangno, Jongro-gu, Seoul 110-744 Korea.
Division of Nuclear Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Nucl Med Mol Imaging. 2017 Sep;51(3):256-260. doi: 10.1007/s13139-016-0462-5. Epub 2016 Dec 9.
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 I whole body scan (WBS) with SPECT/CT. However, they exhibited false-negative results in 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 I therapy within 6 months duration. There was complete treatment response as evaluated by the second post-therapeutic I SPECT/CT and serum thyroglobulin. To our knowledge, renal metastasis from HCTC with positive I but negative F-FDG uptake has not been reported in the literature. This case suggests that I SPECT/CT is useful for lesion localization and prediction of I therapy response.
甲状腺癌肾转移极为罕见。我们报告了一例62岁患有许特莱细胞甲状腺癌（HCTC）并伴有肺、骨及双侧肾转移的女性病例。通过I全身扫描（WBS）及SPECT/CT清晰显示了肾转移病灶。然而，它们在F-FDG PET/CT、肾脏超声及增强CT扫描中显示为假阴性结果。这些发现提示肿瘤具有低葡萄糖代谢且能够摄取放射性碘，这在通常具有相对侵袭性的HCTC中并不常见。该患者在6个月内接受了两个疗程、每次200mCi的I治疗。根据治疗后第二次I SPECT/CT及血清甲状腺球蛋白评估，治疗反应完全。据我们所知，文献中尚未报道过具有I阳性但F-FDG摄取阴性的HCTC肾转移病例。该病例表明I SPECT/CT对于病灶定位及I治疗反应预测是有用的。
