Poorly Differentiated Thyroid Carcinoma

Fig. 14.1

(a–d) The patient underwent PET/CT, which showed hypermetabolic soft tissue at the tracheostomy site. This was more likely an infectious/inflammatory change than malignancy. Otherwise, there were no suspicious hypermetabolic lesions

She received radioimmunotherapy (¹³¹I, activity: 155.23 mCi). The post-therapy ¹³¹I scan did not show uptake in the lateral neck, lungs, or bones. The synthroid dose was adjusted to keep TSH suppressed to close to 0.1 ng/ml.

After 4 months, the patient developed two masses in the left neck, which on MRI measured 5 × 3.8 and 3.0 × 2.3 cm (Fig. 14.2). Thyroglobulin increased until 27 ng/ml.

Fig. 14.2

(a–d) The PET/CT study showed a new, hypermetabolic bilobed mass in the left neck that was suspicious for relapse malignancy (SUV_max 12.0) and (e–h) mild FDG uptake associated with a left upper lobe nodule seen on CT, possibly malignancy or inflammatory change

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