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British Journal of Radiology (2007) 80, e38-e43
© 2007 British Institute of Radiology
doi: 10.1259/bjr/52032397
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Differentiated thyroid cancer presenting with thyrotoxicosis due to functioning metastases

M Haq, MRCP 1 S Hyer, FRCP 2 G Flux, PhD 3 G Cook, FRCR 4 and C Harmer, FRCR 1

1 Thyroid Unit, 2 Medical Physics and 3 Nuclear Medicine, Royal Marsden Hospital, Sutton, Surrey, SM2 5PT and 4 Department of Endocrinology, St Helier's Hospital, Surrey, SW5 1AA, UK


Figure 1
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  		Figure 1. Transbronchial biopsy displaying fragments of follicular thyroid tissue: a thin layer of follicular epithelial cells surrounds central colloid (magnification x 62.5).

 

Figure 2
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  		Figure 2. (a) Computerised tomography of chest at diagnosis (December 2001) demonstrating widespread cannonball metastases in both lungs up to 2.6 cm in diameter. (b) Following repeated 131I therapy (May 2005), only a few small rounded opacities are visible.

 

Figure 3
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  		Figure 3. (a) Post-ablation 131I whole-body scan (March 2002) demonstrates widespread intense irregular uptake in both lungs with further small focal abnormalities in the lower neck, mediastinum and pelvis. (b) Whole-body scan following repeated 131I therapy (April 2004) no longer demonstrates any significant lung uptake, but pelvic uptake has become more obvious. Physiological uptake in the stomach, right colon and bladder can be seen.

 

Figure 4
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  		Figure 4. Absorbed dose map(transaxial view) through both lungs demonstrating absorbed dose distribution following 4.0 GBq 131I (July 2002). Superimposed isodose contours represent areas receiving similar absorbed dose. The colour scale depicts variation in dose with a maximum of 241 Gy.

 




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