Thyroid Cancer - 41-year-old female

History
A 41-year-old female with follicular thyroid carcinoma. Primary diagnosis and nearly total thyroidectomy 11/92, I-131 therapy 12/92.

Original Diagnosis
Elevated thyroglobulin levels were found again on 3/96 (9µg/l). An I-131 whole-body scan showed no focal increase of iodine accumulation. No pathological findings were reported from ultrasound of the neck.

PET Findings
A whole-body FDG PET scan showed a lesion with a high level of FDG uptake in the left paralaryngeal region.

Change in Treatment
The treatment plan based on conventional diagnostic techniques would have been watchful waiting. The PET scan clearly showed local tumor relapse and another resection was performed. Carcinoma was proven histologically. Serum thyroglobulin measurements were negative after surgery.

Courtesy of
Dr. M. Lübeck, Prof. Dr. M. Clausen, University Hospital Eppendorf, Hamburg