A Case of F-18 FDG PET-CT Detection of Sporadic Medullary Thyroid Carcinoma and Cervical Lymph Node Metastasis of Ovarican Cancer

Article information

Kosin Med J. 2012;27(1):51-56

Publication date (electronic) : 2012 June 11

doi : https://doi.org/10.7180/kmj.2012.27.1.51

Joo Wan Seo , Chang Jun Park , Yun Kyung Jeon , Sang Soo Kim , Bo Hyun Kim , In Ju Kim

Department of Internal Medicine, College of Medicine, Pusan National University, Busan, Korea.

Corresponding Author: Bo Hyun Kim, Division of Endocrinology and Metabolism, Department of Internal Medicine, Pusan National University Hospital, 305 Gudeok-ro, Seo-gu, Busan 602-739, Korea. TEL: 051) 240-7678, FAX: 051) 254-3217, pons71@hanmail.net

Received 2012 January 24; Revised 2012 March 01; Accepted 2012 March 06.

Abstract

Medullary thyroid carcinoma (MTC) is derived from the parafollicular or C-cells. As surgical resection is the only curative therapy for MTC, the early diagnosis is important for the patient's survival. F18-Fluorodeoxyglucose positron emission tomography-computed tomography (F-18 FDG PET CT) is a noninvasive imaging method which can be used to diagnose malignant thyroid tumors including recurrent or residual MTC. However, due to the limitations of this technique, it is difficult to differentiate benign from malignant thyroid tumors. We herein present a 47-year-old woman with ovarian cancer history who was found to have thyroid incidentaloma with metastatic cervical lymph node through F-18 FDG PET CT. Thyroid incidentaloma of the patient was examined by fine needle aspiration and the result of this diagnostic procedure showed suspicious MTC. The patient was subsequently diagnosed as having sporadic medullary thyroid carcinoma and metastatic cervical lymph node due to ovarian cancer.

Keywords: Incidentaloma; Medullary thyroid carcinoma; Ovarian cancer; Positron-Emission Tomography

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Article information Continued

Fig. 1

F-18 FDG PET CT. The F-18 FDG PET CT shows focal uptake in left lobe of thyroid gland, both cervical lymph nodes, mediastinal lymph node and both supraclavicular lymph nodes

Fig. 2

Ultrasound finding. Thyroid ultrasound shows hypoechoic nodule of 1.03×0.25 cm in left lobe of thyroid gland (arrow).

Fig. 3

Neck CT. Computed tomography scan shows enlarged supraclaviclar lymph nodes (arrow).

Fig. 4

Microscopic finding of left lobe of thyroid gland. (A) In scanning view of the tumor, mass is confined to thyroid gland. (B) Low-power view of the tumor shows nest pattern of tumor cells and separated by firbrovascular stroma (H&E stain, ×100). (C) High-power view of the tumor shows polygonal or spindle shape of tumor cells (H&E stain, ×400). (D) Synaptophysin stain was positive.

Table 1

Laboratory results of tumor markers and calcitonin