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Intense iodine activity caused by mosquito bite.

Bin Liu¹, Gauri Tilak, Kevin Edwards

¹From the *Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China; and †Department of Radiology, Children's Hospital of Philadelphia, University of Pennsylvania, 34th Street and Civic Center Boulevard, Philadelphia, PA.

Clinical Nuclear Medicine

|October 11, 2013

Summary

Radioiodine remnant ablation for papillary thyroid cancer can show unexpected uptake. A mosquito bite on the thigh mimicked metastatic disease on a post-therapy whole-body scan.

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Area of Science:

Nuclear medicine
Oncology
Pediatric oncology

Background:

Papillary thyroid cancer is the most common type of thyroid cancer.
Radioiodine remnant ablation is a standard treatment to eliminate residual thyroid tissue after surgery.
Whole-body scintigraphy using Iodine-131 ((131)I) is used to assess treatment effectiveness and detect recurrence.

Observation:

A 12-year-old girl treated for papillary thyroid cancer underwent (131)I radioiodine remnant ablation.
Post-therapy (131)I whole-body scintigraphy showed unexpected increased activity in the right upper thigh.
Clinical examination revealed a mosquito bite with hyperemia at the site of increased activity.

Findings:

The increased radioiodine uptake in the thigh was attributed to the inflammatory response at the site of the mosquito bite.
This finding highlights a potential pitfall in interpreting post-therapy (131)I scans.
Inflammatory conditions can cause non-specific iodine uptake.

Implications:

Physicians should consider non-malignant causes of increased radioiodine uptake in post-therapy scans.
Careful clinical correlation is crucial to avoid misinterpreting benign findings as metastatic disease.
This case emphasizes the importance of a thorough patient history and physical examination in nuclear medicine imaging.