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.