A patient who was in remission with papillary thyroid cancer was investigated for recently increasing thyroglobulin levels, I-123 diagnostic whole-body imaging showed a focus of faint uptake centrally in the thyroid bed, whereas an F-18 FDG PET whole-body scan showed two foci in the right side of the neck, most likely in the cervical lymph nodes, and was essentially negative in the thyroid bed. An I-131 postablation scan confirmed all three neck foci, and showed an incidental pericardial effusion. F-18 FDG PET imaging might be helpful in thyroid cancer patients with elevated thyroglobulin levels and equivocal radioiodine scans and may help differentiate residual tumor from a thyroid remnant.