ECE2014 Poster Presentations Clinical case reports Thyroid/Others (72 abstracts)
Follicular thyroid carcinoma presenting with occipital bone and lung metastasis
Muhammed Sacikara 1 , Cevdet Aydin 1 , Fatma Saglam 1 , Nilufer Yildirim Poyraz 2 , Zuhal Kandemir 2 , Aylin Kilic Yazgan 3 , Reyhan Ersoy 1 & Bekir Cakir 1
1Endocrinology And Metabolism Department, Ataturk Education and Research Hospital, Yildirim Beyazit University, Ankara, Turkey; 2Nuclear Medicine Department, Ataturk Education And Research Hospital, Yildirim Beyazit University, Ankara, Turkey; 3Pathology Department, Ataturk Education And Research Hospital, Yildirim Beyazit University, Ankara, Turkey.
When follicular thyroid carcinoma (FTC) is diagnosed, 25% of the patients extrathyroidal invasion, 5–10% lymphatic metastasis and 10–20% distant metastasis are determined. The most common site of distant metastases of FTC is the lung, followed by the bone. The incidence of skull metastasis of FTC is about 2.5–5.8%. Skull metastasis of FTC was located in the skull base and occipital area.
Case: A 60-year-old man admitted at 2006. He was operated for total thyroidectomy at 1998. Histopathology of the surgical specimen was reported as follicular carcinoma of thyroid with features of vascular invasion. 150 mCi of I-131 was given. I-131 whole-body scanning (131I-WBS) after treatment was normal. When the patient admitted to our center, 131I-WBS was performed. It revealed occipital bone and lung metastasis. The patient was operated and occipital bone removed. Histopathology of the surgical specimen was reported as FTC metastasis. 200 mCi additional radioiodine dose was given in 2006. In 2008, 250 mCi additional radioiodine dose was given for recurrence. 131I-WBS revealed occipital bone and multiple defined mass, which were metastasis in both lungs in September 2012. Cranial MR revealed 24×24×22 mm mass in occipital zone. He underwent F-18-FDG PET/CT scan for investigating distant metastasis. On PET scan, an increased of F-18-FDG (SUVmax: 24.1) uptake was seen 23 mm mass which had destructed occipital bone. Also, increased FDG uptake (SUVmax: 10.8) 26 mm mass upper lobe anterior segment in the right lung and 340 mm mass middle lobe medial in the right lung (SUVmax: 2.4) was showed. There were multiple parenchymal lesions, which were in different diameters and in different metabolic activities in both lungs. The patient was given 275 mCi additional radioiodine. The treatment of choice of FTC is total thyroidectomy with radioiodine administration, surgical procedure for metastatic lesion and TSH suppressive therapy.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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