Vertebral hemangioma mimicking a metastatic bone lesion in well-differentiated thyroid carcinoma

The authors report a case of abnormal accumulation of I-131 in a thoracic v ertebra in a patient with a well-differentiated thyroid carcinoma. The pres umptive diagnosis was metastatic bone disease. Further diagnostic work-up c onfirmed a benign bone lesion. Bone metastasis, when shown on I-131 whole-b ody scintigraphy, usually supports a change in the staging and therapeutic approach to a patient with thyroid carcinoma. The authors believe that, alt hough an infrequent lesion, the differential diagnosis of abnormal accumula tion of I-131 in the body of a vertebra in patients with well-differentiate d thyroid carcinoma should raise the possibility of a benign hemangioma. Co mplete work-up of the suggested bone metastatic lesion should be performed before tumor restaging and I-131 therapy is recommended.