Document Detail

Follicular variant of papillary thyroid carcinoma presenting as a toxic nodule by I-123 scintigraphy.
MedLine Citation:
PMID:  20838284     Owner:  NLM     Status:  MEDLINE    
The risk of malignancy in a "hot" thyroid nodule detected by radioiodine scintigraphy is rare. We report a case of a 63-year-old man with a hyperfunctioning nodule demonstrated by radioiodine scintigraphy and cytology suspicious for follicular variant of papillary thyroid carcinoma (FVPTC). There were no locoregional or distant metastases at initial diagnosis. Histopathologic examination following thyroidectomy confirmed the presence of an encapsulated FVPTC. A year into follow-up, his I-131 whole body scan performed following the withdrawal from exogenous thyroid hormone was negative, whereas his serum thyroglobulin (Tg) levels were intermediate. A subsequent PET/CT scan revealed a small, but stable, metabolically active pretracheal lymph node, which on biopsy was confirmed to be stage III FVPTC. In conclusion, the presence of hyperfunctioning thyroid nodule(s) does not preclude malignancy and, therefore, proper cytohistologic evaluation in such patients may help to exclude a coexistent thyroid carcinoma. Patients treated for localized PTC may benefit from serial PET/CT follow-up in the early detection and management of recurrence or distant metastases.
Srinivas Bommireddipalli; Sumina Goel; Ramesh Gadiraju; Alberto Paniz-MondolFi; Ernest Gordon DePuey
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Clinical nuclear medicine     Volume:  35     ISSN:  1536-0229     ISO Abbreviation:  Clin Nucl Med     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-14     Completed Date:  2010-12-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7611109     Medline TA:  Clin Nucl Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  770-5     Citation Subset:  IM    
Division of Nuclear Medicine, Department of Radiology, St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians & Surgeons, New York, NY, USA.
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MeSH Terms
Carcinoma, Papillary, Follicular / pathology*,  radiography,  radionuclide imaging*,  therapy
Fluorodeoxyglucose F18 / diagnostic use
Follow-Up Studies
Iodine Radioisotopes / diagnostic use
Middle Aged
Positron-Emission Tomography
Thyroid Neoplasms / pathology,  radiography,  radionuclide imaging,  therapy
Tomography, X-Ray Computed
Reg. No./Substance:
0/Iodine Radioisotopes; 63503-12-8/Fluorodeoxyglucose F18

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