Adrenal and renal metastases from follicular thyroid cancer

Abstract

Patients with differentiated thyroid cancer may have asymptomatic involvement of renal and/or adrenal gland, particularly if they are elderly and have associated metastases to other organs, which may remain undetected if these patients are not subjected to radioiodine treatment. Our experience also emphasises the role of routine post-radioiodine therapy whole body scan with high degree of clinical suspicion, which may reveal lesions otherwise not discernable in low dose whole body scan. All suspicious lesions should be subjected to structural imaging like ultrasound, CT or MRI for confirmation. In this setting, the role of radioiodine therapy is primarily aimed at palliation that might prolong their survival, probably reduce further spread and thus overall improve the quality of life.

Renal Metastasis from Follicular Thyroid Carcinoma Diagnosed by I-131 Whole-body Scan Mimicking Renal Cell Carcinoma on Contrast-Enhanced Computed Tomography

“…Therefore, MRI cannot differentiate the metastatic tumor from other solid tumors of the kidney. On the contrary, I-131 WBS can diagnose renal metastasis from DTC with high specificity [1][2][3][4][5]. Our result also supports previous studies.…”

“…All had multiple functioning metastases on I-131 WBS. Contrast-enhanced computed tomography (CECT) was performed in the three of five studies where CT findings did not show typical findings of RCC [2][3][4]. Herein, we report a case of follicular thyroid carcinoma (FTC) metastasized to the kidney only, diagnosed by I-131 WBS mimicking RCC on CECT.…”

“…It is important to differentiate between renal cell carcinoma (RCC) and renal metastases in order to determine indications for surgery. Due to its high specificity, I-131 whole body scans (WBS) are suggested to diagnose renal metastasis from DTC [1][2][3][4][5]. There are 20 case reports about renal metastasis from DTC in the literature.…”

“…There are 20 case reports about renal metastasis from DTC in the literature. Among them, only five case reports presented renal metastasis from DTC demonstrated by I-131 WBS (Table 1) [1][2][3][4][5]. All had multiple functioning metastases on I-131 WBS.…”

Rare metastases of differentiated thyroid carcinoma: pictorial review

“…Although adrenal and renal metastases are closely related in terms of anatomy, concomitant adrenal and renal metastases from DTC are exceptional, as only two cases have been reported in the literature (Kumar et al 2005, Malhotra et al 2010. 131 I-avid adrenal metastasis is very rare.…”