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“Tumour sink effect” on the diagnostic or posttreatment radioiodine scan due to sequestration into large-volume functioning metastasis of differentiated thyroid carcinoma influencing uptake in smaller metastatic sites or remnant thyroid tissue: An uncommon but possible phenomenon in thyroid cancer practice


 Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Hospital Annexe; Homi Bhabha National Institute, Mumbai, Maharashtra, India

Correspondence Address:
Sandip Basu,
Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Hospital Annexe, Jerbai Wadia Road, Parel, Mumbai - 400 012, Maharashtra
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/wjnm.WJNM_54_19

Two patients of differentiated thyroid carcinoma are illustrated demonstrating “sink effect” in posttherapeutic and diagnostic radioiodine (I-131) study: (a) in the first case, it masked the other small-volume metastatic sites (pulmonary and paratracheal nodes) in the posttreatment scan, which were clarified following metastatectomy of the large-volume skeletal metastatic lesion, and (b) in the second, interestingly, it masked the remnant thyroid uptake in the first postoperative diagnostic radioiodine study. In both the situations, large-volume highly functioning skeletal metastasis was the cause for the observed “sink effect” and is presented as learning illustrations to the attending physicians. Although uncommon, this is a possible phenomenon in thyroid cancer practice.


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