The authors report a case of abnormal accumulation of I-131 in a thoracic vertebra in a patient with a well-differentiated thyroid carcinoma. The presumptive diagnosis was metastatic bone disease. Further diagnostic work-up confirmed a benign bone lesion. Bone metastasis, when shown on I-131 whole-body scintigraphy, usually supports a change in the staging and therapeutic approach to a patient with thyroid carcinoma. The authors believe that, although an infrequent lesion, the differential diagnosis of abnormal accumulation of I-131 in the body of a vertebra in patients with well-differentiated thyroid carcinoma should raise the possibility of a benign hemangioma. Complete work-up of the suggested bone metastatic lesion should be performed before tumor restaging and I-131 therapy is recommended.

Primary thymic carcinoids are rare tumors in which the tumor cells retain functional somatostatin receptors. In-111-labeled octreotide imaging has been used to diagnose abdominal carcinoids with a sensitivity rate of approximately 87%. The authors describe a case of a recurrent, ectopic cortisol-releasing hormone that produced thymic carcinoid localized as a focal area of increased activity in the upper mediastinum when planar and tomographic octreotide scintigraphy was used. Chest CT and MRI failed to localize the tumor. This may be the first reported case of In-111-labeled octreotide used to identify Cushing's syndrome caused by a cortisol-releasing hormone that produced thymic carcinoid.