E-ISSN 2305-1620 | ISSN 2221-0288
 

Imaging Gamut 


istan Journal of Nuclear Medicine (Volume 7, issue 1)

https://doi.org/10.24911/EJBCMS.7.11

Unusual breast radioiodine uptake in a nonbreastfeeding woman with papillary thyroid carcinoma

Yassir Benameur*, Hasnae Guerrouj, Salah Nabih Oueriagli,Omar Ait Sahel, Imad Ghfir, Nouzha Ben Raïs Aouad

Department of Nuclear Medicine, Farwania Hospital Kuwait

Address for correspondence

Dr Yassir Benameur

Nuclear Medicine Department

IBN-SINA Hospital Center

University Med V-Rabat

Rabat, Morocco

Tel: 0021 2661209162

Email: benameur.yassir@gmail.com


ABSTRACT

Background:

A 48-year-old woman underwent total thyroidectomy for a multinodular goiter. Histopathological examination revealed papillary thyroid carcinoma.

The patient was referred to the nuclear medicine department for ablative dose of iodine-131 iodine (3.7 GBq) and post therapy radioiodine scan. Thyroglobulin level was at 11 ng/ml.


Procedure:

Planar whole-body radioiodine scintigraphy was performed in the anterior and posterior projections 5 days after the ablative dose of 131I. Single-photon emission computed tomography (SPECT-CT) was additionally performed for anatomical localization of the thoracic radioiodine-avid foci.


Findings:

The whole-body radioiodine scan revealed cervical radioiodine uptake, in relation to a post-surgical residue.

The scan also showed two quasi-symmetrical thoracic radioiodine-avid foci located probably outside the pulmonary fields (Figure 1). On the SPECT-CT scan these thoracic foci of radioiodine uptake were seen to correspond to uptake in both breasts (Figure 2).


Conclusion:

Whole-body scintigraphy after 131I ablation showed unusual bilateral focal uptake in the breasts in a patient with papillary thyroid carcinoma. This appears to be a rare case of false-positive uptake in a non lactating woman.


Comments:

The knowledge of the usual sites of radioiodine concentration in the body is essential for the correct interpretation of the whole-body scintigraphy. However, the real pitfall in the correct diagnosis is concentration of 131I in a lesser known site.

Physiological uptake of radioiodine can be observed in a variety of non-thyroidal tissues, breast is one of them, because of its expression of NIS; iodine accumulation in the lactating breast has been recognized for the last 64 years and is now regarded as a usual finding in postpartum patients [1]. However, concentration of radioiodine in non-lactating breasts is rare with the first such case reported by Sitterson in 1962 [2].

Hammami et al. studied the significance of radioiodine uptake by the non-lactating breast [3]. Expressible galactorrhoea and moderately elevated prolactin levels were observed in 48% and 24% of cases, respectively. Other rare causes of breast radioiodine uptake have been described, which include breast fibroadenoma [4] and breast carcinoma [5].

Figure 1. Planar 131I whole-body scan showing two thoracic radioiodine-avid foci probably outside the pulmonary fields

Figure 2. Thoracic SPECT-CT showing radioiodine-avid foci in both breasts: a) transaxial, b) sagittal, c) coronal CT showing glandular breast parenchyma in the area of the radioiodine avid uptake

REFERENCES

  1. Honour AJ, Myant NB, Rowlands EN. Secretion of radioiodine in digestive juices and milk in man. Clin Sci 1952; 11: 449–62.
  2. Sitterson BW, Andrews GA. Introduction to thyroid scanning: introduction to thyroid scanning. Progress in medical radioisotope scanning. Oak Ridge 1962; 279–295.
  3. Hammami MM, and Bakheet S. Radioiodine breast uptake in nonbreastfeeding women: clinical and scintigraphic characteristics. J Nucl Med 1996; 37:26–31.
  4. Berger F, Unterholzner S, Diebold J, Knesewitsch P, Hahn K, Spitzweg C. Mammary radioiodine accumulation due to functional sodium iodide symporter expression in a benign fibroadenoma. Biochem Biophys Res Commun 2006; 349: 1258–63.
  5. Wapnir IL, Goris M, Yudd A, Dohan O, Adelman D, Nowels K, et al. The Na+/Isymporter mediates iodide uptake in breast cancer metastases and can be selectively down-regulated in the thyroid. Clin Cancer Res 2004; 10: 4294–302.


How to Cite this Article
Pubmed Style

Benameur Y, Guerrouj H, Oueriagli SN, Sahel OA, Ghfir I, Aouad NBR. Unusual breast radioiodine uptake in a nonbreastfeeding woman with papillary thyroid carcinoma. Pak J Nucl Med. 2017; 7(1): 51-52. doi:10.24911/PJNMed.7.11


Web Style

Benameur Y, Guerrouj H, Oueriagli SN, Sahel OA, Ghfir I, Aouad NBR. Unusual breast radioiodine uptake in a nonbreastfeeding woman with papillary thyroid carcinoma. http://www.pjnmed.com/?mno=302244 [Access: October 21, 2018]. doi:10.24911/PJNMed.7.11


AMA (American Medical Association) Style

Benameur Y, Guerrouj H, Oueriagli SN, Sahel OA, Ghfir I, Aouad NBR. Unusual breast radioiodine uptake in a nonbreastfeeding woman with papillary thyroid carcinoma. Pak J Nucl Med. 2017; 7(1): 51-52. doi:10.24911/PJNMed.7.11



Vancouver/ICMJE Style

Benameur Y, Guerrouj H, Oueriagli SN, Sahel OA, Ghfir I, Aouad NBR. Unusual breast radioiodine uptake in a nonbreastfeeding woman with papillary thyroid carcinoma. Pak J Nucl Med. (2017), [cited October 21, 2018]; 7(1): 51-52. doi:10.24911/PJNMed.7.11



Harvard Style

Benameur, Y., Guerrouj, H., Oueriagli, S. N., Sahel, O. A., Ghfir, I. & Aouad, N. B. R. (2017) Unusual breast radioiodine uptake in a nonbreastfeeding woman with papillary thyroid carcinoma. Pak J Nucl Med, 7 (1), 51-52. doi:10.24911/PJNMed.7.11



Turabian Style

Benameur, Yassir, Hasnae Guerrouj, Salah Nabih Oueriagli, Omar Ait Sahel, Imad Ghfir, and Nouzha Ben Ras Aouad. 2017. Unusual breast radioiodine uptake in a nonbreastfeeding woman with papillary thyroid carcinoma. Pakistan Journal of Nuclear Medicine, 7 (1), 51-52. doi:10.24911/PJNMed.7.11



Chicago Style

Benameur, Yassir, Hasnae Guerrouj, Salah Nabih Oueriagli, Omar Ait Sahel, Imad Ghfir, and Nouzha Ben Ras Aouad. "Unusual breast radioiodine uptake in a nonbreastfeeding woman with papillary thyroid carcinoma." Pakistan Journal of Nuclear Medicine 7 (2017), 51-52. doi:10.24911/PJNMed.7.11



MLA (The Modern Language Association) Style

Benameur, Yassir, Hasnae Guerrouj, Salah Nabih Oueriagli, Omar Ait Sahel, Imad Ghfir, and Nouzha Ben Ras Aouad. "Unusual breast radioiodine uptake in a nonbreastfeeding woman with papillary thyroid carcinoma." Pakistan Journal of Nuclear Medicine 7.1 (2017), 51-52. Print. doi:10.24911/PJNMed.7.11



APA (American Psychological Association) Style

Benameur, Y., Guerrouj, H., Oueriagli, S. N., Sahel, O. A., Ghfir, I. & Aouad, N. B. R. (2017) Unusual breast radioiodine uptake in a nonbreastfeeding woman with papillary thyroid carcinoma. Pakistan Journal of Nuclear Medicine, 7 (1), 51-52. doi:10.24911/PJNMed.7.11





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