Elif ÖZDEMİR, Şeyda TÜRKÖLMEZ, Cevdet AYDIN, Nilüfer YILDIRIM, Zuhal KANDEMİR, Sabire AKSOY YILMAZ

False Positive Result in the Whole-Body Scan with 131-I in the Follow-up of Differentiated Thyroid Cancer: The Fistula Tract Accompanied by the Suture Granuloma

Differansiye tiroid kanserleri takibinde kullanılan I-131 tüm vücut taraması, postoperatif normal rezidü tiroid dokusu ve rekürren/metastatik hastalıkları tespit etmede ve tedavinin belirlenmesinde önemli bir rol oynar. I-131 , tiroid kanseri tespiti için duyarlı bir gösterge olmasına rağmen radyoaktif iyot tutulumu tiroid dokusu için spesifik değildir. Birçok hastada tüm vücut taramasında yanlış pozitif yoruma neden olabilecek anatomik varyantların ve farklı fizyolojik tutulumların yanısıra tiroid dışı nedenlere bağlı olarak da tutulumlar görülebilir. Bu olgu raporunda yanlış pozitif sonuca neden olan sütür granülomuna eşlik eden fistül traktı sunulmuştur. 47 yaşında papiller tiroid kanseri nedeniyle total tiroidektomi operasyonu geçiren bayan hastaya tanısal amaçlı yapılan I-131 tüm vücut taramasında, boyun orta hatta yanlış pozitif iyot tutulumu tespit edilmiştir. I-131 tüm vücut taramasında tespit edilen bu tutulum; biokimyasal veriler, klinik öykü, fizik muayene, ultrasonografi (US) ve bilgisayarlı tomografi (BT) görüntüleme yöntemleri ile korele edilmiş ve lezyonun sütür granülomuna eşlik eden bir fistül traktı olduğu saptanmıştır. I131 tüm vücut iyot taramada izlenen yanlış pozitif bulgular, gereksiz tedavileri önlemek için diğer görüntüleme yöntemleri, mevcut biyokimyasal veriler, klinik öykü, fizik muayene ile korele edilmelidir.

Diferansiye Tiroid Kanserinin Takibinde Tüm Vücut I-131 Tarama ile Yalancı Pozitiflik Nedeni: Sütür Granülomuna eşlik eden Fistül Traktı

The role of radioiodine-131(I-131) Whole- body scan (WBS) is crucial regarding the management of patients with differentiated thyroid carcinoma (DTC) in detecting normal thyroid remnants and recurrent or metastatic disease. Although I-131 is a sensitive marker for detection of thyroid cancer, radioiodine uptake is not specific for thyroid tissue. According to several reports, various tissues or non-thyroidal pathologic processes were associated with falsepositive WBS with radioiodine. In this case report we reported that the false positive result was present due to the fistula accompanied by the suture granuloma. A 47 year-old woman underwent total thyroidectomy for papillary thyroid carcinoma.A false-positive iodine uptake in the midline neck was determined by a diagnostic I-131 whole body scan. I-131 whole body scan was correlated with ultrasonography (US) and computed tomography (CT) imaging features, biochemical data, clinical history, and physical examination. The lesion was demonstrated to be a fistula tract accompanied by the suture granuloma. The false- positive findings in the I-131 whole-body scan should be confirmed with other imaging modalities, available biochemical data, clinical history, and physical examination in order to avoid unnecessary treatments.

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