Malign melanomlu bir hastada yapılan pozitron emisyon tomografide rastlantısal olarak tespit edilen tiroid papiller karsinom [Incidentally detected thyroid papillary carcinoma on PET in a patient with malignant melanoma]

Abstract

Focal or diffusely increased 18F-fluorodeoxyglucose (18FDG) uptake in thyroid gland are occasionally seen during 18FDG positron emission tomography (PET) scanning. Increased 18FDG uptake in thyroid nodules may be associated with benign or malignant tumours. In our case who was diagnosed as malignant melanoma, focally increased 18FDG uptake in a thyroid nodule was noticed. Thus, fine needle aspiration biopsy of the thyroid nodule was performed. On suspicious findings for the thyroid papillary cancer were reported, total thyroidectomy was performed. Histopathological evaluation revealed the thyroid papillary carcinoma. So, therapy for the incidental thyroid papillary carcinoma was commenced in this case who was under the follow-up for the malignant melanoma.

Keywords

• Thyroid, papillary carcinoma, FDG-PET, thyroid incidentaloma

Malign melanomlu bir hastada yapılan pozitron emisyon tomografide rastlantısal olarak tespit edilen tiroid papiller karsinom

Öz

18F-Florodeoksiglukoz pozitron emisyon tomografi (18FDG PET) görüntülemede tiroid bezinde difüz ya da fokal artmış 18FDG tutulumu ile zaman zaman karşılaşılmaktadır. Tiroid bezindeki nodüllerde artmış 18FDG tutulumu benign ya da malign tümörlere bağlı olabilir. Malign melanom tanısı bulunan olgumuza tümör evrelemesi amacıyla yapılan 18FDG PET/BT esnasında tiroid bezindeki bir nodülde fokal artmış 18FDG tutulumu dikkati çekti. Bu nodüle yapılan ince iğne aspirasyon biyopsisinde tiroid papiller karsinomu (Ca) düşündüren bulgular rapor edilmesi üzerine hastaya total tiroidektomi yapıldı. Histopatolojik olarak papiller tiroid Ca tanısı koyuldu. Bunun üzerine malign melanom tanısıyla takip ettiğimiz bu olgumuza ilave olarak rastlantısal tiroid papiller Ca tedavisi başlandı.

Anahtar Kelimeler

• Tiroid, papiller karsinom, FDG-PET, tiroid insidentaloma

Kaynakça

1. Feldt-Rasmussen U. Iodine and cancer. Thyroid 2001;11(5):483-6.
2. Busaidy NL, Cabanillas ME. Differentiated thyroid can- cer: management of patients with radioiodine nonre- sponsive disease. J Thyroid Res 2012;(6)1:85-9
3. Fırat U, Keleş A, Mızrak B. Kolumnar hücreli varyant papiller tiroid karsinomu: Olgu sunumu ve literatürün gözden geçirilmesi. J Clin Exp Invest 2011;2(3):304-7.
4. Choi JW, Yoon YH, Yoon YH, Kim SM, Koo BS. Char- acteristics of primary papillary thyroid carcinoma with false-negative findings on initial (18)F-FDG PET/CT. Ann Surg Oncol 2011;18(5):1306-11.
5. Ohba K, Nishizawa S, Matsushita A, et al. High inci- dence of thyroid cancer in focal thyroid incidentaloma detected by 18F-fluorodeoxyglucose positron emis- sion tomography in relatively young healthy subjects: results of 3-year follow-up. Endocr J 2010;57(5):395- 401.
6. Salvatori M, Melis L, Castaldi, et al. Clinical significance of focal and diffuse thyroid diseases identified by (18) F-fluorodeoxyglucose positron emission tomography. Biomed Pharmacother 2007;61(8):488-93.
7. Shie P, Cardarelli R, Sprawls K, Fulda KG, Taur A. Systematic review: prevalence of malignant inciden- tal thyroid nodules identified on fluorine-18 fluorode- oxyglucose positron emission tomography. Nucl Med Commun 2009;30(9):742-8.
8. Eloy JA, Brett EM, Fatterpekar GM, et al. The signifi- cance and management of incidental [18F]fluorode- oxyglucose-positron-emission tomography uptake in the thyroid gland in patients with cancer. AJNR Am J Neuroradiol 2009;30(7):1431-4.

9. Kresnik E, Gallowitsch HJ, Mikosch P, et al. Fluorine- 18-fluorodoxyglucose positron emission tomography in the preoperative assessment of thyroid nodules in an endemic goiter area. Surgery 2003;133(3):294-9.