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Incidental Spleen Cyst Mimicking Thyroid Carcinoma Metastasis: False-positive Uptake on Radioiodine Whole Body Scan


  • Mustafa Genç
  • Nazım Coşkun
  • Seyda Türkölmez

Received Date: 29.11.2022 Accepted Date: 08.01.2023 Mol Imaging Radionucl Ther 2023;32(2):175-177 PMID: 37337876

In differentiated thyroid cancer, radioiodine therapy and whole body scans (WBS) are integral part of disease management. We present the case of a 33-year-old woman with multifocal thyroid carcinoma who was treated with radioiodine. Post-treatment WBS scintigraphy showed focal increased I-131 uptake in the spleen, although stimulated thyroglobulin level was not suggestive of distant metastasis. Dynamic magnetic resonance imaging performed later revealed that the finding was an incidental splenic cyst. Radioiodine uptake is not specific to the thyroid tissue. Benign pathologies showing increased radioiodine uptake should be considered in cases with splenic radioiodine accumulation in WBSs.

Keywords: Radioiodine therapy, thyroid cancer, spleen pathologies, whole body scan


Informed Consent: All appropriate patient consent forms were obtained. In this form, the patient gave consent for their pictures and other clinical information to be reported in the journal.

Peer-review: Externally peer-reviewed.

Authorship Contributions

Surgical and Medical Practices: M.G., N.C., S.T., Concept: M.G., N.C., S.T., Design: M.G., N.C., S.T., Data Collection or Processing: M.G., N.C., S.T., Analysis or interpretation: M.G., N.C., S.T., Literature Search: M.G., N.C., S.T., Writing: M.G., N.C., S.T.

Conflict of Interest: No conflict of interest was declared by the authors.

Financial Disclosure: The authors declared that this study received no financial support.


  1. Kitahara CM, Sosa JA. The changing incidence of thyroid cancer. Nat Rev Endocrinol 2016;12:646-653.
  2. Kand P, Asopa R. Metastatic involvement of the spleen in differentiated carcinoma of thyroid. Indian J Nucl Med 2010;25:171-172.
  3. Wartofsky L, Van Nostrand D. Thyroid cancer: a comprehensive guide to clinical management. 2nd ed. Springer, 2006.
  4. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, Pacini F, Randolph GW, Sawka AM, Schlumberger M, Schuff KG, Sherman SI, Sosa JA, Steward DL, uttle RM, Wartofsky L. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 2016;26:1-133.
  5. Oh JR, Ahn BC. False-positive uptake on radioiodine whole-body scintigraphy: physiologic and pathologic variants unrelated to thyroid cancer. Am J Nucl Med Mol Imaging 2012;2:362-385.
  6. Mohan V, Jones RC, Drake AJ 3rd, Daly PL, Shakir KM. Littoral cell angioma presenting as metastatic thyroid carcinoma to the spleen. Thyroid 2005;15:170-175.