PMC6180898_01
(a, b) Pre-operative contrast-enhanced CT scan of the neck and chest. A large enhancing mass lesion with central necrosis in the right lobe of the thyroid causing compression and deviation of the trachea to the left side.
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fig1
Contrast-enhanced CT imaging (Figure 1) performed previously showed a large enhancing mass involving the right lobe and isthmus of the thyroid gland with multiple subcentimetre nodules in bilateral lungs.
(a-f) 18F-FDG PET-CT. (a, b) CT and fused 18F-FDG PET-CT transaxial images showing residual thyroid tissue in the neck, predominantly on the left side; (c) fused 18F-FDG PET-CT transaxial image shows multiple small lung nodules; (d, e) CT and fused 18F-FDG PET-CT transaxial images show a sclerotic lesion in the vertebra with mild FDG uptake; (f) coronal 18F-FDG PET-CT fused image shows minimal FDG uptake in the sellar lesion. 18F-FDG PET-CT, 18-fludeoxyglucose positron emission tomography-CT.
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fig2
Whole-body 18F-fludeoxyglucose positron emission tomography-CT (18F-FDG PET-CT) scan (Figure 2) demonstrated significant residual thyroid tissue in the thyroid bed, multiple skeletal metastases with mild FDG uptake and bilateral pulmonary nodules.
(a-d) MRI of the brain. T
1 weighted image in the sagittal plane (a) showing a mildly hypointense lesion (arrow) based over the sphenoid bone seen in the suprasellar region. The lesion is isointense on sagittal T
2 weighted image (b) and does not show any bleeding or necrosis within. T
1 and T
2 weighted images in the coronal plane (c, d) showing the lesion (arrows) in the suprasellar region with sparing of normal pituitary (outlined arrow). The sphenoid sinus (asterisk) is also normal.
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fig3
Post-therapy I-131 whole body scan. Anterior and posterior images show a remnant in the thyroid bed with intense iodine uptake, multiple iodine-avid skeletal metastases and mild iodine uptake in the lesion in the sellar region (outlined arrow).
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fig4
A post-therapy scan (Figure 4) revealed an intensely iodine-avid remnant in the thyroid bed, multiple skeletal metastasis and faint uptake in the sellar region.