scholarly journals A False Positive I-131 Metastatic Survey Caused by Radioactive Iodine Uptake by a Benign Thymic Cyst

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Avneet K. Singh ◽  
Adina A. Bodolan ◽  
Matthew P. Gilbert
Keyword(s):  
Thyroid Cancer ◽  
False Positive ◽  
Differentiated Thyroid Cancer ◽  
Radioactive Iodine ◽  
Case Reports ◽  
Distant Metastases ◽  
The United States ◽  
Thymic Cyst ◽  
Pathological Findings ◽  
Thymic Cysts

Thyroid carcinoma is the most common endocrine malignancy in the United States with increasing incidence and diagnosis but stable mortality. Differentiated thyroid cancer rarely presents with distant metastases and is associated with a low risk of morbidity and mortality. Despite this, current protocols recommend remnant ablation with radioactive iodine and evaluation for local and distant metastasis in some patients with higher risk disease. There are several case reports of false positive results of metastatic surveys that are either normal physiologic variants or other pathological findings. Most false positive findings are associated with tissue that has physiologic increased uptake of I-131, such as breast tissue or lung tissue; pathological findings such as thymic cysts are also known to have increased uptake. Our case describes a rare finding of a thymic cyst found on a false positive I-131 metastatic survey. The patient was taken for surgical excision and the final pathology was a benign thymic cyst. Given that pulmonary metastases of differentiated thyroid cancer are rare, thymic cysts, though also rare, must be part of the differential diagnosis for false positive findings on an I-131 survey.

scholarly journals Causes of False-Positive Radioactive Iodine Uptake in Patients with Differentiated Thyroid Cancer

2021 ◽  
Vol 9 (6) ◽  
Author(s):  
Karin Wu ◽  
Uzoezi Ozomaro ◽  
Robert Flavell ◽  
Miguel Pampaloni ◽  
Chienying Liu
Keyword(s):  
Thyroid Cancer ◽  
False Positive ◽  
Differentiated Thyroid Cancer ◽  
Radioactive Iodine ◽  
Imaging Modality ◽  
Whole Body ◽  
Cross Sectional ◽  
Cross Sectional Imaging ◽  
Patient’S History ◽  
Radioactive Iodine Uptake

Abstract Purpose Radioactive iodine (RAI) whole-body scan is a sensitive imaging modality routinely used in patients with differentiated thyroid cancer to detect persistent and recurrent disease. However, there can be false-positive RAI uptake that can lead to misdiagnosis and misclassification of a patient’s cancer stage. Recognizing the causes of false positivity can avoid unnecessary testing and treatment as well as emotional stress. In this review, we discuss causes and summarize various mechanisms for false-positive uptake. Recent Findings We report a patient with differentiated thyroid cancer who was found to have Mycobacterium avium complex infection as the cause of false-positive RAI uptake in the lungs. Using this case example, we discuss and summarize findings from the literature on etiologies of false-positive RAI uptake. We also supplement additional original images illustrating other examples of false RAI uptake. Summary False-positive RAI uptake may arise from different causes and RAI scans need to be interpreted in the context of the patient’s history and corresponding cross-sectional imaging findings on workup. Understanding the potential pitfalls of the RAI scan and the mechanisms underlying false uptake are vital in the care of patients with differentiated thyroid cancer.

scholarly journals Shifting Paradigms and Debates in the Management of Well-differentiated Thyroid Cancer

2009 ◽  
Vol 1 (1) ◽  
pp. 13-18 ◽  
Author(s):  
Ashok R Shaha
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Radioactive Iodine ◽  
Central Compartment ◽  
The United States ◽  
The Past ◽  
Poorly Differentiated ◽  
Well Differentiated ◽  
Radioactive Iodine Ablation

ABSTRACT The incidence of thyroid cancer has almost quadrupled over the past 30 years in the United States, a large number of which are less than 2 cm in size. There have been several paradigms in the management of well-differentiated thyroid cancer. The common debate in the past was total vs less than total thyroidectomy, however recently there is more interest in evaluation of fine needle aspiration of thyroid nodules, and intraoperative management in relation to the central compartment. The debate about elective central compartment nodal dissection vs observation has generated considerable controversy in the recent literature. Postoperative follow-up with thyroglobulin and ultrasound has become the mainstay of postoperative evaluation. Radioactive iodine ablation has been used in selected patients with advanced or aggressive thyroid cancer. While risk stratification continues to be an important facet in the evaluation of thyroid cancer, low risk patients are rarely offered radioactive iodine ablation. Understanding of the details of the histopathology is crucial, especially dividing the patients between well-differentiated and poorly differentiated thyroid cancer. PET scanning has been useful in the follow-up of patients with poorly differentiated, insular or tall cell thyroid cancer. External radiation therapy is used in selected patients where gross residual disease was present or there are painful bony metastases. Considerable research has been undertaken to identify specific molecular markers and their applicability for targeted therapy. This manuscript describes the current debates and shifting paradigms in the management of well-differentiated thyroid cancer.

Curcumin enhances the membrane trafficking of sodium iodide symporter and augments radioiodine uptake in dedifferentiated thyroid cancer cells via suppression of PI3K-AKT signaling pathway

2021 ◽  
Author(s):  
Li Zhang ◽  
Shichen Xu ◽  
Xian Cheng ◽  
Jing Wu ◽  
Xiaowen Wang ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Membrane Trafficking ◽  
Differentiated Thyroid Cancer ◽  
Sodium Iodide ◽  
Radioactive Iodine ◽  
Distant Metastases ◽  
Sodium Iodide Symporter ◽  
Akt Signaling Pathway ◽  
Radioiodine Uptake ◽  
Thyroid Cancer Cells

Radioactive iodine (RAI) is commonly used to treat differentiated thyroid cancer (DTC). A major challenge is dedifferentiation of DTC with the loss of radioiodine uptake. Patients with distant metastases have...

scholarly journals A Search for Causes of Rising Incidence of Differentiated Thyroid Cancer in Children and Adolescents after Chernobyl and Fukushima: Comparison of the Clinical Features and Their Relevance for Treatment and Prognosis

2021 ◽  
Vol 18 (7) ◽  
pp. 3444
Author(s):  
Valentina Drozd ◽  
Vladimir Saenko ◽  
Daniel I. Branovan ◽  
Kate Brown ◽  
Shunichi Yamashita ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Children And Adolescents ◽  
Differentiated Thyroid Cancer ◽  
Age Groups ◽  
Distant Metastases ◽  
Lifestyle Changes ◽  
Radiation Doses ◽  
Related Factors ◽  
Fukushima Accident ◽  
Tumor Stages

The incidence of differentiated thyroid cancer (DTC) is steadily increasing globally. Epidemiologists usually explain this global upsurge as the result of new diagnostic modalities, screening and overdiagnosis as well as results of lifestyle changes including obesity and comorbidity. However, there is evidence that there is a real increase of DTC incidence worldwide in all age groups. Here, we review studies on pediatric DTC after nuclear accidents in Belarus after Chernobyl and Japan after Fukushima as compared to cohorts without radiation exposure of those two countries. According to the Chernobyl data, radiation-induced DTC may be characterized by a lag time of 4–5 years until detection, a higher incidence in boys, in children of youngest age, extrathyroidal extension and distant metastases. Radiation doses to the thyroid were considerably lower by appr. two orders of magnitude in children and adolescents exposed to Fukushima as compared to Chernobyl. In DTC patients detected after Fukushima by population-based screening, most of those characteristics were not reported, which can be taken as proof against the hypothesis, that radiation is the (main) cause of those tumors. However, roughly 80% of the Fukushima cases presented with tumor stages higher than microcarcinomas pT1a and 80% with lymph node metastases pN1. Mortality rates in pediatric DTC patients are generally very low, even at higher tumor stages. However, those cases considered to be clinically relevant should be followed-up carefully after treatment because of the risk of recurrencies which is expected to be not negligible. Considering that thyroid doses from the Fukushima accident were quite small, it makes sense to assess the role of other environmental and lifestyle-related factors in thyroid carcinogenesis. Well-designed studies with assessment of radiation doses from medical procedures and exposure to confounders/modifiers from the environment as e.g., nitrate are required to quantify their combined effect on thyroid cancer risk.

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