Thyroid Carcinoma Detected by 18f-Fluorodeoxyglucose Positron Emission Tomography Among Individuals without Prior Evidence of Thyroid Disease: Relevance and Clinicopathologic Features |
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| Affiliation: | 1. Departments of Endocrinology, Instituto Português de Oncologia de Lisboa;2. Departments of Nuclear Medicine Department, Instituto Português de Oncologia de Lisboa;3. Departments of University Clinic of Endocrinology, Faculdade de Ciências Médicas, Universidade Nova de Lisboa.;1. University of Leipzig, Department of Endocrinology and Nephrology;2. University of Leipzig, Clinic of Psychosomatic Medicine and Psychotherapy;3. University of Leipzig, IFB Adiposity Diseases;4. University of Leipzig, Institute for Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics;1. Department of Clinical and Experimental Medicine, Section of Geriatrics, University of Parma, Italy;2. Geriatric Rehabilitation Department, University Hospital of Parma, Parma, Italy;3. Division of Endocrinology, Diabetes, and Metabolism, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania;4. Department of Psychiatry, VU University Medical Center/GGZ inGeest, Amsterdam, the Netherlands;5. National Institute on Aging, National Institutes of Health, Baltimore, Maryland.;1. College of Physicians and Surgeons, Columbia University, New York, New York;2. Department of Internal Medicine and Medical Disciplines, “Sapienza” University of Rome, Italy |
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| Abstract: | ObjectiveThe expanding use of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) has contributed to an increasing number of thyroid incidentalomas. The present study aimed to estimate the prevalence of 18F-FDG-PET thyroid incidentalomas and evaluate the clinicopathologic features of thyroid malignancies detected by 18F-FDG-PET.MethodsWe reviewed all 18F-FDG-PET exams performed at the Portuguese Institute of Oncology, Lisbon, between 2007 and 2012 (n = 9,374). The inclusion criteria were focal thyroid uptake and absence of known thyroid disease.ResultsFocal thyroid uptake was observed in 60 out of 9,374 18F-FDG-PET exams (prevalence of 0.64%). Fineneedle aspiration cytology (FNAC) was performed in 23 patients and reported as malignant in 14 cases (56.5% primary thyroid carcinoma; 4.3% secondary malignancy), as benign in 7 cases (30.5%) and as follicular lesion of undetermined significance in 2 cases (8.7%). Fourteen patients had surgery. A final histologic diagnosis of papillary thyroid carcinoma was established in 12 cases (52.2%). Three were multifocal (25.0%); 8 had extrathyroidal extension (66.7%); 5 had angioinvasion (41.7%); 3 had lymph nodes metastases (25.0%) and 2 showed lung metastases (16.7%). Overall, 91.7% were classified as intermediate or high risk. All patients had radioiodine therapy. At the last observation (mean follow-up was 29.9 months), persistent or recurrent disease was identified in 4 patients (33.3%) and none died from thyroid malignancy.ConclusionsThyroid carcinomas disclosed by 18F-FDG-PET are associated with aggressive histological criteria likely to carry a worse prognosis. (Endocr Pract. 2014;20:1129-1136) |
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