Outcome and follow-up
Follow-up MRI brain demonstrated stable post-surgical changes. A
post-RAI 131I scan demonstrated bilateral residual
functioning thyroid tissue in the thyroid bed without iodine-avid
disease elsewhere. A six-week follow-up FDG-PET scan demonstrated mildly
increased tracer uptake in the left thyroid bed (SUVmax3.3) corresponding to a 12mm level IV lymph node and two subcentimetre
lymph nodes (SUVmax 2.5). Two new skeletal foci
(SUVmax 3.6 and 3.7) were also noted in the manubrium
and T6 vertebral body. Thyroglobulin continued to be elevated at 620
ug/L with thyroglobulin antibodies <1.0 IU/mL. The patient is
currently asymptomatic and awaiting follow-up FDG-PET scan. Treatment of
the presumed bony metastasis with intraveoous zoledronic acid has been
considered.