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DOI: 10.1055/s-0044-1788737
A Rare and Intriguing Case of Papillary Thyroid Carcinoma with Tumor Thrombus Extending into the Right Ventricle: Documentation with 131I-NaI-SPECT/CT, MRI, and 18F-FDG-PET/CT
Autoren
Abstract
A unique case of papillary carcinoma of the thyroid with an extensive tumor thrombus extending into the right ventricle is presented. The patient was a known case of solid variant of papillary carcinoma of thyroid, post three cycles of radioiodine therapy, had reported for a diagnostic 131I-NaI scintigraphy as a part of the workup for planning the next 131I therapy. Clinically, the patient was asymptomatic. 131I-NaI scintigraphy showed an arcuate pattern concentration of tracer in the upper mediastinum, which descended up to the lower mediastinum. A 131I-NaI single photon emission computed tomography/computed tomography (SPECT/CT) showed a tracer avid tumor with an extensive tumor thrombus extending from the left brachiocephalic vein to the right ventricle. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) and magnetic resonance imaging (MRI) demonstrated similar findings. The patient was decided to be managed with tyrosine kinase inhibitors as surgical intervention was not deemed possible due to the involvement of major vessels and the high risk of bleeding.
Publikationsverlauf
Artikel online veröffentlicht:
05. August 2024
© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
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References
- 1 Gardner RE, Tuttle RM, Burman KD. et al. Prognostic importance of vascular invasion in papillary thyroid carcinoma. Arch Otolaryngol Head Neck Surg 2000; 126 (03) 309-312
- 2 Quencer KB, Friedman T, Sheth R, Oklu R. Tumor thrombus: incidence, imaging, prognosis and treatment. Cardiovasc Diagn Ther 2017; 7 (Suppl. 03) S165-S177
- 3 Kaufmann C. Die Struma Maligna: Primäres Sarkoma und Carcinoma strumae. Deutsche Zeitschrift für Chirurgie 1879; 11 (5–6): 401-402
- 4 Gill SM, Hassan A, Bashir H, Shafiq W. I-131 avid tumor thrombus in a case of poorly differentiated thyroid cancer. Mol Imaging Radionucl Ther 2023; 32 (02) 178-180
- 5 Yamagami Y, Tori M, Sakaki M, Ohtake S, Nakahara M, Nakao K. Thyroid carcinoma with extensive tumor thrombus in the atrium. Gen Thorac Cardiovasc Surg 2008; 56 (11) 555-558
- 6 Holt WL. Extension of malignant tumors of thyroid into great veins and right heart. JAMA 1934; 102: 1921-1924
- 7 Hasegawa S, Otake Y, Bando T, Cho H, Inui K, Wada H. Pulmonary dissemination of tumor cells after extended resection of thyroid carcinoma with cardiopulmonary bypass. J Thorac Cardiovasc Surg 2002; 124 (03) 635-636
- 8 Sugimoto S, Doihara H, Ogasawara Y, Aoe M, Sano S, Shimizu N. Intraatrial extension of thyroid cancer: a case report. Acta Med Okayama 2006; 60 (02) 135-140
- 9 Gui Y, Wang JY, Wei XD. Middle thyroid vein tumor thrombus in metastatic papillary thyroid microcarcinoma: a case report and review of literature. World J Clin Cases 2022; 10 (10) 3213-3221
- 10 Mazzaferri EL, Jhiang SM. Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer. Am J Med 1994; 97 (05) 418-428
- 11 Thompson NW, Brown J, Orringer M, Sisson J, Nishiyama R. Follicular carcinoma of the thyroid with massive angioinvasion: extension of tumor thrombus to the heart. Surgery 1978; 83 (04) 451-457