Cervical Vertebral Metastasis Mimicking Thyroid Uptake on Planar 123I-MIBG Images

Thyroid MIBG uptake is a quite common, typically benign finding; however, abnormal neck activity must not be reflexively misattributed to the thyroid gland. We present the case of a 10-year-old girl with neuroblastoma undergoing 123I-MIBG scintigraphy. Initial planar images demonstrated intense tracer uptake in the neck, appearing more prominent on the anterior view and mimicking thyroid accumulation. Subsequent SPECT/CT was instrumental in correctly localizing the activity to the C7 vertebral body, confirming a site of osseous metastatic disease rather than physiological uptake.