Follicular thyroid carcinoma metastasizing to rare sites and exhibiting variable inter-lesional heterogeneity on 18F-fluorodeoxyglucose positron emission tomography/computed tomography and 131I

Abstract

A patient of differentiated follicular thyroid carcinoma with unusual sites of metastases is illustrated with 131 I and 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) imaging findings. The described case harbored extremely rare metastasis to the urinary bladder with multi-organ metastatic disease (including unusual sites of right bronchus and hepatic metastases). There was inter-lesional heterogeneity among the metastatic lesions with regard to the 131 I and FDG uptake in the aforementioned lesions. The detection of such heterogeneity has important implications for patient management in metastatic differentiated thyroid carcinoma.

Unusual Metastatic Sites and Radioiodine Uptake in Patients of Differentiated Thyroid Carcinoma with Atypical Clinical Presentations: Utilization of 131I-Whole-Body Scintigraphy with Regional SPECT/CT

“…7 Metastasis to the urinary bladder in DTC is extremely rare, with only a few cases reported in the literature. [8][9][10][11][12] The majority of these cases presented with complaints of hematuria, which led to the identification of lesions in the urinary bladder. Similar to this, our case 1 presented with hematuria that led to further investigation and incidental detection of thyroid nodule on 18 F-FDG-PET/CT.…”

Case report: Large follicular thyroid carcinoma with multiple cervical lymph node metastases

“…FTC is mainly metastasized via the blood circulation, and once the primary thyroid tumor is suspected to be FTC, patients with suspected FTC in other organs should undergo CT, MRI, PET/CT and other related examinations for a comprehensive evaluation. Parghane et al reported on a 54-year-old male FTC patient presenting with cough and occasional hemoptysis for 1 year and hematuria for 6 months ( 12 ). A CT scan showed heterogeneously enhancing soft tissue lesions in the hilar region of the right lung, right lateral wall of the urinary bladder, segment III of the liver, and destruction of the left 5th rib.…”