Extrathyroidal uptake from thyroid carcinoma on [99m]Tc-pertechnetate scintigraphy

Three cases of imaging with 99mTc-pertechnetate [[99m]TcO[4]] and unusual positive lymph node uptake in the neck are reported hereby. Two cases were later diagnosed to be well-differentiated thyroid carcinoma, [DTC] with nodal metastasis. The third was a confirmed case of carcinoma thyroid that had presented with mass in the neck soon after surgery, being prepared for ablative dose of radioactive iodine [131]I. All three were young females under 40 years of age. These 3 cases signify that extra thyroidal areas of uptake on a routine thyroid scan with [99m]TcO[4] can some time be due to thyroid carcinoma with regional metastases. Foci of metastasis in patients with DTC may be incidentlly detected with [99m]TcO[4] scan. Multinodular goiter with palpable lymph node should always be investigated for exclusion of malignancy. The patients underwent near total thyroidectomy and radical neck dissection; histopathology confirmed the scan findings

Role of99m TC-methoxy-isobutyl isonitrile scintimammography in the evaluation of palpable breast masses

99mTc-methoxy-isobutyl-isonitrile [99mTc-MIBI] was utilized as a tumor localizing agent in the evaluation of palpable breast masses. A total of 24 patients with palpable breast masses, along with 8 women with no palpable breast pathology [control population] underwent 99mTc-MIBI scintimammography. Multiple planar views were obtained. Focal area of increased tracer uptake corresponding to the palpable lump was considered as malignant. The scintimammograms indistinguishable from the control population were considered as benign that is no tracer uptake in the palpable mass was considered as benign. All of the 14 breast carcinoma lumps of 13 patients [one case had two lumps in the same breast] were correctly detected using 99mTc-MIBI scintimammography. Twelve of the 14 lumps were correctly diagnosed as benign in 9 patients [one patient had 4 masses and another had 2]. Abnormal focal 99mTc-MIBI uptake was observed only in one fibroade- and one fibrocystic disease patient. The sensitivity and specificity was 100 and 87% espectively. It was concluded that 99mTc-MIBI scintimammography shows a high sensitivity and specificity for carcinoma breast and therefore has the potential to reduce the large number of unnecessary breast biopsies