Endocrine

, Volume 46, Issue 3, pp 682–683

Small cell carcinoma of the thyroid gland with a solid brain metastasis detected by F-18-FDG PET/CT

Authors

    • Department of Nuclear Medicine, Thyroid Center and PET/CT CentreOncology Institute of Southern Switzerland
  • Massimo Salvatori
    • Institute of Nuclear MedicineCatholic University of Rome
  • Luca Giovanella
    • Department of Nuclear Medicine, Thyroid Center and PET/CT CentreOncology Institute of Southern Switzerland
Endocrine imaging

DOI: 10.1007/s12020-013-0084-y

Cite this article as:
Treglia, G., Salvatori, M. & Giovanella, L. Endocrine (2014) 46: 682. doi:10.1007/s12020-013-0084-y
A 77-year-old man underwent fine needle aspiration biopsy of a 3.5 cm nodule of the right thyroid lobe. Cytology showed small cells with scant cytoplasm; on immunocytochemistry, the cells showed high proliferative activity and cytoplasmic expression for neuroendocrine marker synaptophysin. These findings were suggestive for a small cell carcinoma of the thyroid gland. Therefore, the patient underwent fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT) for staging. PET/CT showed an area of increased F-18-FDG uptake corresponding to the right thyroid nodule (Fig. 1a, b). Furthermore, an area of increased radiopharmaceutical uptake was detected in the brain, corresponding to a lesion located in the left parietal lobe on low-dose CT (Fig. 1a, c). Biopsy of the brain lesion was suggestive for small cell carcinoma. The final diagnosis based on pathology and F-18-FDG PET/CT findings was small cell carcinoma of the thyroid gland with brain metastasis. The patient was addressed to chemotherapy and radiation therapy, but he died 6 months after the begin of therapy for disease progression.
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Fig. 1

Maximum intensity projection F-18-FDG PET image (a), axial low-dose CT (b1b2) and fused PET/CT images (c1c2) showed an area of increased radiopharmaceutical corresponding to a 3.5 cm nodule in the right thyroid lobe (yellow arrows) with a maximal standardized uptake value of 9. Furthermore, an area of increased radiopharmaceutical uptake was detected in the brain, corresponding to a solid lesion located in the left parietal lobe (red arrows) on low-dose CT with a maximal standardized uptake value of 11. The final diagnosis based on pathology and F-18-FDG PET/CT findings was small cell carcinoma of the thyroid gland with brain metastasis

Small cell carcinoma is a very aggressive neuroendocrine tumour usually arising from the lung, but the primary site may be rarely and virtually located in any organ [1, 2]. Previous reports demonstrated that F-18-FDG PET/CT could provide relevant information in staging patients with small cell carcinoma located in different anatomical sites [1, 2]. Furthermore, F-18-FDG PET/CT has been demonstrated to be a useful imaging technique in aggressive thyroid tumours [3], providing useful information about staging, restaging and prognosis.

To the best of our knowledge, our case is the first in the literature which evaluated a metastatic small cell carcinoma of the thyroid gland by F-18-FDG PET/CT. In our case this functional imaging method has been very useful in correctly staging this rare aggressive thyroid tumour.

Conflict of interest

The authors declare that they have no conflicts of interest.

Copyright information

© Springer Science+Business Media New York 2013