-
Views
-
Cite
Cite
Junichi Yasui, Toshimasa Shimizu, Takao Ando, Shinjiro Uchida, Hidetaka Shibata, Atsushi Kawakami, Successful Visualization of an Indeterminate Hepatic Metastasis From Thyroid Carcinoma Using Contrast-Enhanced CT and Contrast-Enhanced Ultrasound, The Journal of Clinical Endocrinology & Metabolism, Volume 98, Issue 7, 1 July 2013, Pages 2639–2640, https://doi.org/10.1210/jc.2013-1178
Close - Share Icon Share
Extract
A 76-year-old female underwent hemithyroidectomy in 2009 because of a thyroid tumor that was suspected to be papillary thyroid carcinoma. Histological examination revealed the tumor to be poorly differentiated papillary thyroid carcinoma with vascular invasion but without lymph node metastasis or local invasion. Serum levels of thyroglobulin (Tg) remained high (∼200 ng/mL) and increased thereafter postoperatively. However, no metastatic lesions were detected by chest-to-abdominal plain computed tomography (CT), bone scintigraphy, brain magnetic resonance imaging, upper abdominal ultrasound, or positron emission tomography-CT (Figure 1A). In addition, 131-I whole body scans after total thyroidectomy were negative (Figure 1B). Although not strictly indicated due to the high basal Tg level, a stimulation test was performed with 0.9 mg of recombinant human TSH for 2 consecutive days. Serum levels of Tg increased from 2853 to 11 579 ng/mL, suggesting the existence of viable thyroid cancer tissues. The patient underwent contrast-enhanced CT (CECT) to explore the rare sites of metastasis such as the pancreas (1) and bladder (2), which revealed a hepatic mass (Figure 2A).
