Virchow Node From Prostate Carcinoma by 18F-Choline PET/CT.

F-choline PET/CT is increasingly being used during the follow-up of prostate cancer and is bringing us valuable information for the delineation of local and distant nodal recurrence in patients with hormone-resistant poorly differentiated cell types. Lymphatic spreading usually involves pelvic and retroperitoneal levels, being unusual at supraclavicular levels. We report a 75-year-old man with unsuspected involvement of Virchow node from prostate cancer observed using F-choline PET/CT.

Esophageal Cancer Diagnosed by Thyroid Scintigraphy.

We report a 34-year-old man referred because of increasing dysphagia secondary to goiter. Thyroid scintigraphy and SPECT/CT images helped to recognize an unsuspected esophageal dilation due to a poorly differentiated adenocarcinoma arising at the lower end of the esophagus. Further examinations are mandatory when abnormal activities are observed during thyroid scintigraphy.

Intrathoracic stomach mimicking bone metastasis from thyroid cancer in whole-body iodine-131 scan diagnosed by SPECT/CT.

The whole-body iodine-131 scintigraphy is an imaging technique in monitoring patients with a history of thyroid cancer. Although the rate of false positives is negligible, it is not nonexistent. We report the case of an intervened and treated patient for thyroid cancer with good clinical and biochemical response. Scintigraphic findings were consistent with unsuspected bone metastasis. Fused SPECT/CT data allowed accurate diagnosis of giant diaphragmatic hernia associated with intrathoracic stomach, a very rare pathology that can lead to false positive results.

Hallazgo incidental de osteocondroma pélvico / Incidental finding of pelvic osteochondroma

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Diagnóstico diferencial de masa hepática mediante gammagrafía con hematíes marcados y octreótido / Differential diagnosis of a hepatic mass by 99mTc-labelled red cells and octreotide scintigraphy

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Recidiva locorregional diferida de mesotelioma pleural / Deferred Locoregional Recurrence of Pleural Mesothelioma

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Intrathoracic stomach mimicking bone metastasis from thyroid cancer in whole-body iodine-131 scan diagnosed by SPECT/CT

SUMMARY The whole-body iodine-131 scintigraphy is an imaging technique in monitoring patients with a history of thyroid cancer. Although the rate of false positives is negligible, it is not nonexistent. We report the case of an intervened and treated patient for thyroid cancer with good clinical and biochemical response. Scintigraphic findings were consistent with unsuspected bone metastasis. Fused SPECT/CT data allowed accurate diagnosis of giant diaphragmatic hernia associated with intrathoracic stomach, a very rare pathology that can lead to false positive results.

[Age of menopause in patients with differentiated thyroid cancer treated with radioiodine]. / Edad de menopausia en pacientes tratadas con I131 por cáncer diferenciado de tiroides.

INTRODUCTION: Differentiated thyroid cancer (DTC) is an increasingly frequent endocrinological disease. Radioiodine is a key component of treatment. OBJECTIVE: To analyze the effects of I(131) therapy on ovarian and reproductive function. MATERIAL AND METHODS: We retrospectively analyzed data from 202 women treated with radioiodine for DTC in our service from 1985-2008. Data on age at menopause in patients and their mothers and sisters, menstrual history, fertility and neonatal abnormalities were collected. RESULTS: Menopause occurred in 34 patients at follow-up. The mean age at menopause in patients was 49.94+/-3.45 while that in their mothers and sisters was 49.20+/-5.37 and 48.73+/-3.74 years, respectively. Three patients had transient amenorrhea. No infertility or neonatal alterations were found. CONCLUSIONS: In our series, menopause did not occur earlier in patients than in their first degree relatives. No significant alterations in neonatal health, fertility or menstruation were found.

Thymic uptake after high-dose I-131 treatment in patients with differentiated thyroid carcinoma: A brief review of possible causes and management / Captación tímica después del tratamiento a dosis elevadas con I-131 en pacientes con carcinoma diferenciado de tiroides: revisión breve de posibles causas y manejo

PURPOSE: To report five cases of patients diagnosed with differentiated thyroid carcinoma (DTC) with uptake in the thymic area after high-dose treatment with I-131 and to evaluate the potential causes and therapeutic management. METHODS: Five cases of young female patients with a mean age of 36.6 years (24-43) who had been treated with a mean dose of 106mCi of I-131 (100-150mCi) showing tracer uptake in the thymic area are reported. An I-131 whole-body scan (131I-WBS) was performed 7 days after therapeutic dose administration to each patient. Anterior and posterior planar images, followed by SPECT/CT of the head, neck and superior mediastinum were acquired in all patients. Thyroglobulin levels were measured with and without hormone replacement therapy in all cases. Samples taken from the superior mediastinum were sent to pathology for analysis, which confirmed the presence of thymic tissue. Results: Two patients underwent elective total thymectomy due to the gross characteristics of the gland, local 131-I uptake, and high thyroglobulin levels. The remaining three patients had already undergone thymectomy as part of neck dissection during initial surgery, and no further invasive interventions were therefore performed. Pathological examination revealed no metastases in these five patients. CONCLUSIONS: Thymus visualization in young patients after administration of therapeutic doses of I-131 seems to be a more common finding than usually thought. Absence of metastasis in the thymus despite high thyroglobulin levels was confirmed in all cases. Based on these results, we suggest that a more expectant and less aggressive therapeutic approach could be used. We also suggest that I-131 therapy for DTC should be considered in classification of the potential causes of true thymic hyperplasia in the subgroup of patients recovering from a stressor

OBJETIVOS: Descripción de cinco casos de pacientes diagnosticados de carcinoma diferenciado de tiroides (CDT) con captación en el área del timo después de un tratamiento con alta dosis de I-131, y evaluar las posibles causas y manejo terapéutico. MÉTODOS: Presentamos cinco casos de mujeres jóvenes con una edad media de 36,6 años (24-43), que fueron tratadas con una dosis media de 106mCi de I-131(100-150) que mostraron captación del trazador en las región tímica. Se ralizaron rastreos de cuerpo completo a los 7 días de la administración de la dosis a todos los pacientes, se realizaron imágenes planares de cuerpo completo en proyecciones anterior, posterior y SPECT/TAC de cabeza, cuello y mediastino superior. Valorándose también los niveles de tiroglobulinas con y sin tratamiento sustitutivo hormonal. En todos los casos se confirmó mediante anatomía patológica que la captación visualizada en el mediastino superior correspondía a tejido tímico. RESULTADOS: Dos pacientes fueron sometidas a una timectomía total debido a las características macroscópicas de la glándula, la captación de I-131 y los altos niveles de tiroglobulina. En los otros tres pacientes la timectomía ya se había realizado previamente como parte de la disección del cuello en el tratamiento quirúrgico inicial por lo que se deciden no reintervenir. Los cinco casos fueron informados por anatomía patológica como negativos para metástasis. CONCLUSIONES: La visualización del timo en pacientes jóvenes tras la administración de dosis terapéuticas de I-131 es un hallazgo más frecuente de lo que pudiéramos pensar. En todos los casos se confirmó la ausencia de metástasis en el timo a pesar de los niveles elevados de tiroglobulinas. A la vista de estos resultados planteamos la posibilidad de una actitud terapéutica menos agresiva y expectante. También proponemos que la terapia metabólica para el CDT se debe tomar en cuenta en la clasificación de las causas probables de la hiperplasia tímica verdadera en el subgrupo que incluye a los pacientes en recuperación que han sido sometidos a un factor estresante

Hallazgo incidental de hernia diafragmática derecha durante la realización de tomografía computarizada de emisión monofotónica de perfusión miocárdica con 99mTc-tetrofosmín / ncidental finding of diaphragmatic hernia during 99mTc-tetrofosmin photon emission computed tomography

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