case_images: PMC10860522_01
case_images: Neck ultrasonography (A) and contrast-enhanced computed tomography (B) show an internally heterogeneous mass at the lower pole of the right lobe of the thyroid gland with an indistinct boundary with the surrounding tissue. 99mTc-MIBI scintigraphy (C) shows abnormal accumulation in the superior mediastinum and multiple bone. 18F-FDG PET/CT also shows a weak accumulation in the superior mediastinum (D) and a strong accumulation of multiple bone (E). 18F-FDG PET/CT = 18F-fluorodeoxyglucose-positron emission tomography/computed tomography; 99mTc-MIBI = 99m Tc-methoxy isobutyl isonitrile.
case_images: uaad003f1.jpg
case_images: PMC10860522_01_uaad003f1.jpg
case_images: uaad003-F1
case_images: Neck ultrasonography and CT revealed a heterogeneous internal mass extending from the inferior pole of the right lobe of the thyroid gland to the upper mediastinum (Figure 1A and B). The boundary between the thyroid gland, oesophagus, and trachea remains unclear. 99m Tc-methoxy isobutyl isonitrile (99mTc-MIBI) scintigraphy and 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET)/CT revealed multiple bone accumulations (Figure 1C and D) and a weak accumulation in the superior mediastinum (Figure 1E).
case_images: Osteolytic lesions of the scapula preoperatively (A) show sclerotic changes at 6 months postoperatively (B).
case_images: uaad003f2.jpg
case_images: PMC10860522_01_uaad003f2.jpg
case_images: uaad003-F2
case_images: CT showed sclerotic changes in the bilateral rib and scapular osteolytic lesions at 6 months postoperatively (Figure 2), indicating a high possibility of a brown tumour.
case_images: PMC10860522_02
case_images: Plain radiographs of the femur (A) and tibia (B) show multiple osteolytic lesions. Neck ultrasonography (C) and computed tomography (D) show an 80 mm tumour behind the left lobe of the thyroid gland. 99mTc-MIBI scintigraphy (E) shows abnormal accumulation in the superior mediastinum. There is no accumulation in the bone lesions. 99mTc-MIBI = 99m Tc-methoxy isobutyl isonitrile.
case_images: uaad003f3.jpg
case_images: PMC10860522_02_uaad003f3.jpg
case_images: uaad003-F3
case_images: Plain radiographs revealed multiple osteolytic changes in the clavicle, scapula, ribs, spine, pelvis, and femur (Figure 3A and B). Neck ultrasonography and CT revealed an 80 mm low-absorption mass in the dorsal left lobe of the thyroid gland (Figure 3C and D). 99mTc-MIBI showed abnormal accumulation in the dorsal left lobe of the thyroid gland but no accumulation in the bone lesions.
case_images: Osteolytic lesions of the pelvis preoperatively (A) show sclerotic changes at 6 months postoperatively (B).
case_images: uaad003f4.jpg
case_images: PMC10860522_02_uaad003f4.jpg
case_images: uaad003-F4
case_images: CT showed sclerotic changes in the pelvic osteolytic lesion 6 months postoperatively (Figure 4A and B).