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01.12.2012 | Case report | Ausgabe 1/2012 Open Access

Journal of Medical Case Reports 1/2012

Lung nodule detected by F-18 fluorodeoxyglucose positron emission tomography-computed tomography in patients with papillary thyroid cancer, negative 131I whole body scan, and undetectable serum-stimulated thyroglobulin levels: two case reports

Zeitschrift:
Journal of Medical Case Reports > Ausgabe 1/2012
Autoren:
Chan-Hee Jung, Hyeon-Jeong Goong, Bo-Yeon Kim, Jung-Mi Park, Jeong-Ja Kwak, Chul-Hee Kim, Hyun-Sook Hong, Sung-Koo Kang, Ji-Oh Mok
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1752-1947-6-374) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

CHJ and JOM contributed to patients’ diagnosis and treatment. HJG and BYK participated in the literature review. JMP and HSH contributed to radiology-related issues and JJK contributed to histology-related issues. CHK and SKK participated in interpretation of the case. All authors read and approved the manuscript.

Abstract

Introduction

When a pulmonary nodular lesion is detected by F-18 fluorodeoxyglucose positron emission tomography-computed tomography in a patient with post-surgical papillary thyroid carcinoma with undetectable serum-stimulated thyroglobulin levels and negative 131I whole body scan, diagnosis and management of the nodule may be confusing.

Case presentation

We describe two post-surgical patients with papillary thyroid carcinoma who showed pulmonary nodular lesions detected by F-18 fluorodeoxyglucose positron emission tomography-computed tomography. In both cases serum-stimulated thyroglobulin levels were undetectable and nodular lesions were not detected by 131I whole body scan. In the first case, a 64-year-old Asian woman showed one focal increased fluorodeoxyglucose uptake lesion in the right lower lobe of one of her lungs. Based on the histologic study, the pulmonary nodular lesion was diagnosed as a solitary pulmonary metastasis from papillary thyroid carcinoma. In the second case, a 59-year-old Asian woman showed a new pulmonary nodule in the right lower lobe. The computed tomography scan of her chest revealed a 9mm nodule in the anterior basal segment and another tiny nodule in the posterior basal segment of the right lower lobe. Six months later, both nodules had increased in size and miliary disseminated nodules were also seen in both lungs. Based on their histology, the pulmonary nodular lesions were considered to be primary lung adenocarcinoma.

Conclusions

The present cases emphasize that physicians should be cautious and make efforts for an accurate diagnosis of pulmonary nodules detected on F-18 fluorodeoxyglucose positron emission tomography-computed tomography in patients with papillary thyroid carcinoma with no evidence of metastasis such as negative 131I whole body scan and undetectable stimulated serum thyroglobulin levels.

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Zusatzmaterial
Authors’ original file for figure 1
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Authors’ original file for figure 2
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