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Case Reports
. 2019 Apr-Jun;34(2):134-136.
doi: 10.4103/ijnm.IJNM_128_18.

Papillary Carcinoma Thyroid Metastases Presenting as Thyrotoxicosis Post Thyroidectomy - A Case Report

Kanala Sai Krishnaja  1 , Ramya Priya Rallapeta  1 , Mehabunnisa Shaik  1 , Ranadheer Manthri  1 , Suresh Vaikkakara  2 , T C Kalawat  1
Affiliations
Case Reports

Papillary Carcinoma Thyroid Metastases Presenting as Thyrotoxicosis Post Thyroidectomy - A Case Report

Kanala Sai Krishnaja et al. Indian J Nucl Med. 2019 Apr-Jun.

Abstract

Thyrotoxicosis can occur in the setting of differentiated thyroid cancer due to functioning metastases. Here, we report a case of a 63 year old woman with papillary carcinoma thyroid who underwent total thyroidectomy and defaulted for further scheduled treatment with high dose radioactive iodine therapy. 2 years after total thyroidectomy, she presented with signs and symptoms of thyrotoxicosis and a scalp swelling on the right side of frontal region. Excision biopsy revealed metastatic deposits of papillary carcinoma thyroid. Even after withdrawal of thyroxine, her serum thyrotropin did not rise and thyroglobulin levels were high, raising the suspicion of high volume tumour burden. I-131 whole body scan was done and it revealed radio iodine avid cervical lymph nodes along with functioning lung and skeletal metastases.

Keywords: Functioning metastases; papillary carcinoma thyroid; thyrotoxicosis.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Low dose I-131 whole-body scan showing evidence of radioactive iodine-avid foci in right frontal bone, lungs with no residual radioactive iodine avid tissue in thyroid bed. Physiological concentration seen in urinary bladder region
Figure 2
Figure 2
Low dose I-131 whole-body scan showing evidence of radioactive iodine-avid multiple cervical lymph nodal, bilateral lung, right frontal bone and right pelvic bone metastases. Physiological radiotracer concentration seen in urinary bladder region
Figure 3
Figure 3
Post 200 mCi high-dose radioactive iodine-131 scan showing tracer concentration in right frontal bone, thyroid bed, cervical lymph nodes, bilateral lungs, multiple bilateral ribs, thoracic vertebrae and pelvic bones
See this image and copyright information in PMC

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