Document Detail


Incidental thyroid "PETomas": clinical significance and novel description of the self-resolving variant of focal FDG-PET thyroid uptake.
MedLine Citation:
PMID:  21251421     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Recent series of incidental thyroid activity on fluorodeoxyglucose positron emission tomography (FDG-PET) in patients evaluated for nonthyroidal malignancy, which we refer to as a "PEToma," have suggested that such lesions are associated with a significant incidence of primary thyroid cancer.
METHODS: We retrospectively reviewed 6457 FDG-PET scans performed on 4726 patients from May 2004 to March 2007. We reviewed the cases of patients whose PET or computed tomography (CT) radiology reports described PET uptake within the thyroid to identify incidence and malignant potential of PETomas and evaluate their clinical and histopathologic features.
RESULTS: We found that 160 patients (3.4%) had incidental, abnormal FDG uptake in the thyroid gland, 103 of whom had focal uptake (the PEToma group). Of these patients, 50 (48%) underwent further investigations, including ultrasonography in 48, fine-needle aspiration cytology in 38 and computed tomography in 3. Ten patients underwent surgery, and papillary thyroid cancer was identified in 9. The remaining 53 patients with PETomas underwent no further investigation. Interestingly, 5 patients who had focal uptake within the thyroid showed either spontaneous resolution on repeat FDG-PET (self-resolving) or no focal lesion on subsequent ultrasonography (false-positive).
CONCLUSION: The incidence of papillary thyroid cancer in the present series is similar to that in the literature. Although some patients will show self-resolving or false-positive focal thyroid uptake on FDG-PET, we believe that, if the patient's clinical status permits, the evaluation of patients with incidental thyroid PEToma should include ultrasonographic confirmation and fine-needle aspiration cytology.
Authors:
Hidefumi Nishimori; Roger Tabah; Marc Hickeson; Jacques How
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Canadian journal of surgery. Journal canadien de chirurgie     Volume:  54     ISSN:  1488-2310     ISO Abbreviation:  Can J Surg     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-29     Completed Date:  2011-06-07     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  0372715     Medline TA:  Can J Surg     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  83-8     Citation Subset:  IM    
Copyright Information:
© 2011 Canadian Medical Association
Affiliation:
Division of Surgical Oncology, McGill University Health Centre, Montréal, Que., Canada.
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MeSH Terms
Descriptor/Qualifier:
Adult
Biopsy, Fine-Needle
Carcinoma, Papillary / pathology,  radionuclide imaging*,  ultrasonography
Female
Fluorodeoxyglucose F18 / diagnostic use
Humans
Incidental Findings*
Male
Middle Aged
Positron-Emission Tomography*
Radiopharmaceuticals / diagnostic use
Retrospective Studies
Thyroid Neoplasms / pathology,  radionuclide imaging*,  ultrasonography
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18
Comments/Corrections

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