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Coexistant iodine-negative pleural metastasis with iodine-positive lung and bone metastases in a patient with differentiated thyroid cancer.

Pleural metastasis from differentiated thyroid cancer is extremely rare. We describe a 32-year-old man with an iodine-negative pleural metastasis from a follicular variant of papillary thyroid carcinoma, using I-131 whole-body scan (I-131 WBS) and I-131 SPECT/CT techniques. I-131 WBS combined with I-131 SPECT/CT after radioiodine therapy showed pulmonary and skeletal iodine-avid metastases. The pleural mass had no ability to accumulate radioiodine. Thyroid carcinoma metastatic to the pleural was histologically confirmed by transthoracic biopsy. The practical interest in this unique case is that iodine-negative pleural metastasis and iodine-positive lung and bone metastases coexisted in the same patient.