PMC6352645_01
Whole body fluorodeoxyglucose positron emission tomography-computed tomography images performed for identification of source of malignancy in a patient with right occipital condyle metastases, showing the fluorodeoxyglucose avid left lobe of thyroid nodule, (a) fluorodeoxyglucose avid lytic lesion with associated soft tissue in the right occipital condyle. (b) Maximum intensity image (c) did not reveal any other site of abnormal metabolic activity. Magnetic resonance imaging images (d and e) showing the lesion in the right occipital condyle with involvement of the hypoglossal nerve
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F1
FDG PET-CT [Figure 1] showed a metabolically active lytic lesion with minimal soft tissue (21 mm x 16 mm) in the right condyle of the occipital bone.
Whole body iodine scan images (pretherapy anterior [a] and posterior [b] showing iodine avid focal lesions in the neck with iodine avidity in the right occipital condyle metastases. Intense iodine uptake is appreciated in the posttherapy scan (c: Anterior and d: Posterior)
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F2
Whole body iodine scan [Figure 2] performed as per routine protocol, after 15 days of external beam radiotherapy, showed thyroid remnant with an iodine-avid osseous lesion in the occipital bone. Repeat MRI [Figure 2] (at 5 months after radioactive iodine treatment) showed residual lytic lesion in the right side of skull base extending to the hypoglossal canal with engulfment of the hypoglossal nerve.
Whole body iodine scan images (6 months after initial iodine therapy anterior [a] and posterior [b] showing ablation of the iodine avid focal lesions in the neck. There is near complete response in the lesion in the right occipital condyle. Mild iodine uptake is appreciated in the posttherapy scan after second dose of high-dose radioiodine therapy (c: Anterior and d: Posterior)
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F3
She underwent a repeat whole body iodine scan at 6 months which showed minimal iodine uptake in the occipital condyle [Figure 3].