Incidental Follicular Thyroid Carcinoma on F-18 FDG PET CT: Case Report

| Posted in: Science

Journal name: The Malaysian Journal of Medical Sciences
Original article title: Incidental Follicular Thyroid Carcinoma Detected on F-18 FDG PET CT Imaging for Breast Cancer Staging: A Case Report
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Original source:

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Author:

Alex KHOO Cheen Hoe,, Fadzilah HAMZAH, Mohamed Ali Abdul KHADER


The Malaysian Journal of Medical Sciences:

(A peer-reviewed, open-access journal)

Full text available for: Incidental Follicular Thyroid Carcinoma Detected on F-18 FDG PET CT Imaging for Breast Cancer Staging: A Case Report

Year: 2014

Copyright (license): CC BY 4.0


Download the PDF file of the original publication


Summary of article contents:

Introduction

The incidence of thyroid incidentalomas has risen significantly due to advancements in imaging technologies, with studies indicating that approximately 2.3% of patients undergoing FDG PET-CT for non-thyroid-related conditions may have these findings. Importantly, the malignancy risk associated with thyroid incidentalomas can be as high as 47%, particularly in cases with increased focal uptake of F-18 fluorodeoxyglucose (FDG) and calcification. This report discusses a case involving a patient who, while being evaluated for breast cancer, was found to have a calcified thyroid incidentaloma that was later confirmed to be follicular thyroid carcinoma.

Detection of Malignancy in Thyroid Incidentalomas

The correlation between focal FDG uptake in thyroid lesions and the likelihood of malignant pathology is critical in assessing thyroid incidentalomas. The detection rate of these incidentalomas presents a dilemma; while they are often benign, their characteristics, such as increased FDG uptake and associated calcification, can indicate higher malignancy potential. For example, a case involving a 41-year-old woman undergoing FDG PET-CT detected a metabolically active thyroid nodule. Subsequent fine-needle aspiration yielded inconclusive results, but a right hemithyroidectomy confirmed follicular thyroid carcinoma. This emphasizes the necessity for vigilant monitoring and surgical evaluation of incidental lesions identified through imaging.

Conclusion

The presence of a calcified thyroid incidentaloma with increased FDG uptake necessitates further investigation due to its association with a higher risk of malignancy. Clinicians should prioritize early intervention for such lesions to enable appropriate treatment and improve patient outcomes. This case serves as a critical reminder of the implications of incidental findings on imaging studies and the importance of thorough diagnostic pathways in managing thyroid nodules.

FAQ section (important questions/answers):

What is the detection rate of thyroid incidentalomas in FDG PET-CT?

The detection rate of thyroid incidentalomas in patients undergoing FDG PET-CT is approximately 2.3%. This number reflects its increasing prevalence as imaging technology advances.

What are the risks associated with thyroid incidentalomas?

Thyroid incidentalomas carry a significant risk of malignancy, with some studies indicating rates as high as 47%. Factors such as focal FDG uptake and calcification further elevate this risk.

What was the clinical case reported in the study?

A case involved a 41-year-old lady diagnosed with left breast cancer who was found to have a calcified thyroid incidentaloma, which was later confirmed to be follicular thyroid carcinoma after further investigation.

Why is increased FDG uptake in thyroid nodules concerning?

Increased FDG uptake in thyroid nodules indicates higher glycolysis and glucose consumption, suggesting a greater risk of malignancy. Focal lesions with such uptake require further evaluation.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Incidental Follicular Thyroid Carcinoma on F-18 FDG PET CT: Case Report”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Cancer:
Cancer refers to a group of diseases characterized by uncontrolled cell growth, leading to the formation of tumors and potential metastasis to other body parts. In the context of this text, it specifically relates to the risk associated with thyroid incidentalomas detected during FDG PET-CT imaging, with varying malignant potential.

2) Disease:
Disease denotes an abnormal condition affecting the body or mind. In the article, it emphasizes the health consequences of thyroid incidentalomas, particularly highlighting thyroid carcinoma as a significant concern arising from incidental findings in patients undergoing cancer imaging for unrelated issues.

3) Study (Studying):
Study represents an investigation or research conducted to uncover findings or insights. The article discusses various studies pointing out the prevalence and malignancy risks associated with thyroid incidentalomas, thereby illustrating how clinical evidence influences medical approaches in managing thyroid health during cancer surveillance.

4) Post:
Post indicates a time following an event or condition. In this context, it relates to the follow-up actions taken after initial diagnosis, such as the post-ablation scans and subsequent therapies administered, which are pivotal for managing cancer and evaluating treatment effectiveness in cases of thyroid carcinoma.

5) Relative:
Relative pertains to something identified or understood in relation to something else. This term highlights the comparative risks associated with thyroid nodules; the article explores the relative implication of calcification and metabolic activity in increasing the likelihood of malignancy within detected incidentalomas.

6) Natan:
Nathan likely refers to a co-author of a referenced study within the article. The mention underscores collaborative research that adds credibility to the findings presented about thyroid incidentalomas, specifically emphasizing the importance of shared expertise and knowledge in advancing medical understanding and treatment strategies for thyroid cancer.

7) Patel:
Patel refers to another co-author associated with the research. This name points to the collaborative nature of clinical studies regarding thyroid incidentalomas. The inclusion of multiple authors indicates a breadth of research insights, essential for robust analysis and improved understanding of diagnostic imaging implications in thyroid health.

8) Table:
Table typically refers to an organized arrangement of data or information. In the context of this article, it may pertain to the inclusion or reference of data tables showcasing statistics or findings on thyroid incidentalomas. Tables serve as a vital tool in summarizing complex data for easier interpretation in studies.

9) Meli:
Meli likely refers to an author cited in the studies discussed within the article. The presence of this name indicates the breadth of research available regarding thyroid incidentalomas. It enhances the reader's understanding that multiple experts contributed to the collective knowledge on thyroid cancer detection and management.

10) Khoo:
Khoo appears to be another referenced author contributing to the research findings. The citation of various authors, including Khoo, highlights the collaborative effort crucial for validating findings on the risks associated with thyroid incidentalomas, thereby emphasizing the collaborative nature of medical research in this domain.

11) Radiotherapy:
Radiotherapy is a treatment method using targeted radiation to destroy cancerous cells. Within the article, it plays a role in highlighting treatment strategies for thyroid carcinoma following unforeseen findings from imaging, showcasing its importance in patient management when cancer is detected incidentally during scans for other conditions.

12) Discussion:
Discussion refers to the analytical segment of research where findings are interpreted and contextualized. Here, it implies a critical evaluation of the implications of the study’s results regarding thyroid incidentalomas, addressing the potential risks of malignancy and the significance of correctly interpreting PET scan outcomes.

13) Medicine:
Medicine denotes the science and practice of diagnosing, treating, and preventing disease. In this context, it underlines the medical relevance of detecting thyroid incidentalomas during cancer imaging and the need for an informed clinical approach to manage the complex implications for patient health effectively.

14) Reason:
Reason signifies a cause or justification for an action. In the article, this word relates to explaining the necessity for further investigation of detected thyroid incidentalomas due to their potential for malignancy, particularly when signs like calcification or abnormal FDG uptake are observed.

15) Hand:
Hand can symbolize skill or craft in performing tasks. Here, it underscores the dexterity and expertise required in medical procedures, such as evaluating imaging results and conducting surgical interventions for thyroid incidentalomas. The term also emphasizes the critical role of healthcare professionals in patient care.

16) Pur:
Poor refers to a lack or deficiency in quality. In the article, it indicates inadequate performance or uptake of FDG in normal thyroid tissue, highlighting the contrast with abnormal or malignant nodules that exhibit increased metabolic activity. It emphasizes the challenges in distinguishing between benign and malignant lesions.

Other Science Concepts:

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Discover the significance of concepts within the article: ‘Incidental Follicular Thyroid Carcinoma on F-18 FDG PET CT: Case Report’. Further sources in the context of Science might help you critically compare this page with similair documents:

Breast cancer, Case report, Histopathological examination, Malignancy, Malignant tumor, Thyroid gland, Risk of malignancy, Computed tomography, Imaging modalities, Positron Emission Tomography, Metastatic breast cancer, Malignant Tumour, Thyroid Carcinoma, Radioactive iodine, Differentiated thyroid carcinoma, Metabolically active, Thyroid Lesions, Whole body scan, Complete thyroidectomy, Thyroid incidentalomas, FDG PET-CT, Calcified thyroid incidentaloma, Focal uptake pattern, SUVmax, Follicular thyroid carcinoma, Thyroglobulin (Tg) level, Radioactive iodine remnant ablation, Focal fluorodeoxyglucose avidity, Malignancy risk factors, Calcification in thyroid gland, Thyroid disease diagnosis, Malignancy risk, Thyroid malignancy, Thyroid nodule, Focal FDG uptake, Thyroglobulin level, Clinical research study, Standard uptake values, Incidentaloma investigation, PET-CT, FDG-avidity, SUV, Increased FDG uptake, Focally increased uptake, Focal thyroid lesions, Calcified thyroid nodules, FDG, Incidentaloma, Focal uptake, Increased uptake, Diffuse FDG uptake, High standard uptake values, Thyroid nodules with calcification, Increased risk of malignancy, Non-thyroid cancer, Fine-needle aspiration histology, Thyroid FDG-PET incidentaloma, Focally increased uptake of FDG, Solitary thyroid nodules.

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