Dipyridamole Tl-201 Myocardial SPECT in the Diagnosis and Management of a Patient with Left Main Coronary Artery Disease

Lungs and bones are the most common sites of distant metastasis from differentiated thyroid cancer. In this paper, we report a case of papillary thyroid carcinoma with lung and multiple bone metastases in the absence of nodal dissemination. Refractory metastases were displayed on serial I-131 scans, but no bone lesion was seen on her Tc-99m MDP scintigraphy. Tc-99m MDP scan is not appropriate to screen skeletal metastasis in patients with thyroid cancer. Our refractory case with negative BRAF-V600E mutation disputes the role of BRAF mutation as a prognostic marker in PTC.