Gamma probe-guided resection and scanning with Tc-99m MIBI of a local recurrence of follicular thyroid carcinoma

A 30-year-old woman underwent two operations for multinodular goiter and fo llicular thyroid carcinoma. The residual thyroid tissue was ablated by I-13 1 therapy. After 7 years of follow-up, Tc-99m MIBI and I-131 scintigraphy w ere performed, because her serum thyroglobulin level was much higher compar ed with the control analysis performed in the sixth year. Tc-99m MIBI showe d pathologic accumulation, which could be consistent with a local recurrenc e, whereas the results of I-131 scintigraphy were negative. The locally rec urring follicular thyroid carcinoma was resected using a gamma probe and Tc -99m MIBI. The thyroglobulin level decreased to a normal level after surger y. This case shows that the intraoperative use of a gamma probe with Tc-99m MIBI allows localization of recurrent thyroid tissue in the scarred area i n patients with increased radionuclide accumulation, and scanning of the af fected area using the gamma probe may be helpful in determining whether res ection is complete.