Case Author(s): J. Philip Moyers, M.D. and Henry D. Royal, M.D. , 5/17/96 . Rating: #D3, #Q3

Diagnosis: Metastatic Thyroid Carcinoma

Brief history:

This patient has a known history of papillary carcinoma of the thyroid with diffuse metastatic disease to the lung.


Anterior and posterior images from whole body I-131 scintigram

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View second image(tr). Spot image from same study

View third image(tr). Anterior and posterior images 20 days later

Full history/Diagnosis is available below

Diagnosis: Metastatic Thyroid Carcinoma

Full history:

This 6 YO child had a total thyroidectomy 6 weeks prior to whole body radioiodine imaging for papillary carcinoma of the thyroid. The patient has no prior exposure to head and neck radiation. This examination was performed after a 30 mCi therapy dose.


30 mCi I-131 (sodium iodide) p.o. (administered by the Division of Radiation Oncology)


Initial whole body images demonstrate diffuse uptake throughout the lungs as well as uptake within the neck. The absolute amount of the radioiodine within the lung was estimated by counting a known amount of activity during the whole body acquisition. A follow-up examination was performed 20 days later to estimate the biological halflife of the radioiodine. From this data the radiation dose to the lung could be estimated. No correction for attenuation was done.


Treatment with I-131 in a patient with a diffuse lung metastasis carries a small risk of acute interstitial pneumonitis, which can, in severe cases, be fatal. In this unusual patient, the estimated dose to the lung was about 600 rads. This dose is below the amount likely to cause interstitial pneumonitis.

ACR Codes and Keywords:

References and General Discussion of Thyroid Scintigraphy (Anatomic field:Face, Mastoids, and Neck, Category:Neoplasm, Neoplastic-like condition)

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Case number: tr004

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