ABSTRCT

Patients with follicular carcinoma of thyroid may have asymptomatic involvement of adrenal gland and associated metastases to other organs, which may remain undetected for long time if not diagnosed, treated and followed up properly. A very rare case of adrenal metastasis from follicular carcinoma of thyroid, five years after total thyroidectomy is presented. The patient also had synchronous involvement of bones including an unusual site in upper end of left tibia. Here, emphasis is given on awareness of the possibility of unique metastatic deposits of follicular carcinoma of thyroid at unexpected sites as this has a significant impact on clinical decision-making and prognosis of the patients. DOI: http://dx.doi.org/10.3329/bjnm.v17i1.22499 Bangladesh J. Nuclear Med. 17(1): 97-103, January 2014

Introduction: A good number of hyperthyroid patients may show delayed recovery of Thyroid Stimulating Hormone (TSH) level in clinically evident euthyroid condition after radioiodine therapy. This group of patients need to be addressed in therapeutic decision making. The purpose of the study was to evaluate the duration and pattern of lag in TSH recovery after I -131 therapy and the relationship between clinical parameters with stable thyroid function status. Materials and Methods:Total 192 hyperthyroid patients treated with I-131 were included in this study. These patients were followed up clinically and biochemically at three month, six month and one year after radioiodine therapy. Patients having suppressed TSH with normal Free Triiodothyronine (FT3) / Free Thyroxin (FT4) level and clinically euthyroid condition were followed-up for one year without giving antithyroid drug. Results Conclusion:Lagging state of TSH may be unexpectedly prolonged in some hyperthyroid patients treated with I-131. These patients should be followed up with both TSH and thyroid hormone levels. Most of them do not require further therapy with short period of time.

Ectopic thyroid is a rare entity that can appear at any age with different presentations. In this study we are reporting four cases of ectopic thyroid gland at different ages; two cases at childhood, one at adolescent and one at adult life. Among the two children, one having ectopic thyroid at the level of hyoid bone, presented with anterior neck swelling with no other symptom and another one having a lingual ectopic thyroid presented with features of hypothyroidism and obstructive features. The cases of adolescent and adult age are very rare cases of dual ectopic thyroid and ectopic thyroid tissue coexisting with normal thyroid gland respectively. Both of them presented with anterior neck swelling, with additional complaints of dysphagia and foreign body sensation by the adolescent patient. All the cases, ectopic thyroids were detected by Ultrasonogram and confirmed by radionuclide (99mTc) thyroid scan. DOI: http://dx.doi.org/10.3329/bjnm.v17i1.22503 Bangladesh J. Nuclear Med. 17(1): 116-124, January 2014