Case presentation:

• Female.
• 45 y.o. -Right hip pain durin exercise.
• History of resected melanoma 2 years before.
• Plain X rays of pelvis and right limb were normal.
• Since pain persited, a CT scan was ordered.

Teaching points:

• PET/CT is indicated for staging and re-staging of melanoma.
• The technique has high sensitivity for detecting bone marrow involvement.
• Although conventional bone scanning is sueful, PET/CT has the power of detecting also soft tissue involvement (in this case, however, the thyroid finding does not add to the prognosis).
• Thyroid metastases from melanoma are no frequent. One paper reports on 5 incidental findings of thyroid metastases with FDG: 2 from melanoma, 2 from colotrectal cancer, 1 from gastric cancer.
•  Primary malignant thyroid carcinoma, especially papillary type, also take up FDG.