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Case Report Thyroid Cancer
Figure 1: Whole-body scintigraphy after
radioiodine 131 treatment for thyroid cancer
metastasis reveals strong uptake near the scalp
A Contamination of external sites with secretions or excretory products
can mimic metastases and yield false positives at a rate of 0.3% in the
head and neck. 12
As illustrated in this case, a focus of increased I-131 uptake at a site rarely
associated with metastases from differentiated thyroid cancer should
prompt consideration of alternate etiology, such as contamination from
secretory or excretory products. Accurate interpretation of this I-131
WBS was aided by the repositioning technique employed by the nuclear
medicine technologist; such strategy may prevent unnecessary workup
for metastases in other cases. n
C (A) Whole-body scintigraphy performed nine days after receiving 192 mCi of radioiodine
131 demonstrates uptake in the upper mediastinum metastasis (red arrow) and in an
unexpected focus near the scalp (blue arrow); (B) repositioning of the coiffure identifies
the source of this unexpected focus of uptake; (C) uptake is also demonstrated on the
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