Warthin’s Tumor: A Diagnostic Challenge as a Metastatic Mimicker on Post-I-131 Therapy Scan

TL;DR

A rare case shows how Warthin’s tumor can mimic thyroid cancer metastasis on I-131 scans, leading to potential misdiagnosis.

Contribution

This case highlights the diagnostic challenge of false-positive I-131 uptake in non-thyroidal lesions.

Findings

Warthin’s tumor showed I-131 uptake, mimicking metastatic thyroid cancer on post-therapy scans.

False-positive iodine uptake can lead to incorrect staging and unnecessary interventions in thyroid cancer follow-up.

Abstract

We present a rare case with an incidental finding of Warthin’s tumour demonstrating I-131 uptake on a post-therapy whole-body scan in a patient treated for thyroid cancer with total thyroidectomy. The unexpected radioiodine concentration in the parotid region raised initial concern for metastatic disease, illustrating how non-thyroidal lesions can mimic pathological findings in post-ablative imaging. This case highlights a well-recognised diagnostic challenge in nuclear medicine: false-positive I-131 uptake. Differentiating benign radioiodine-avid lesions from true metastases is critical to prevent incorrect staging, unnecessary interventions, and inappropriate management decisions in thyroid cancer follow-up.

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