Ortega F, Maldonado A, Marañes P, Montz R, Pérez-Castejón M J, Melgarejo M, Ruiz J A, Carreras J L
Centro PET Complutense, Madrid 28040, España.
Rev Esp Med Nucl. 1999;18(1):50-4.
The value of whole body PET-FDG in the evaluation of metastases has been demonstrated in a wide variety of tumors. In this report, we present the case of a patient with antecedent of papillary thyroid carcinoma, who was operated twelve years ago, and submitted to an ablative dose of residual thyroid tissue through 131I, being the levels of thyroglobulin normals. After twelve years of evolution, the patient refers bag pain and respiratory trouble, appearing in the CT image suspicious of metastases in right pulmonary base. The levels of thyroglobulin were shown increased, being the 131I scan negative. A whole body PET-FDG study was performed in order to exclude metastases of his malignant process, showed multiple high FDG uptake focus in brain, cerebellum, neck, chest, lymphatic nodes and bone, suggestive of dedifferentiated disease These findings were confirmed subsequently in the clinic evolution. Therefore, whole-body PET-FDG is a complementary diagnostic technique for study patients with CDT (Thyroid Differentiated Carcinoma) with 131I scan negative and rising thyroglobulin levels.
全身PET-FDG在多种肿瘤转移灶评估中的价值已得到证实。在本报告中,我们介绍了一例既往有乳头状甲状腺癌病史的患者,该患者12年前接受了手术,并通过131I对残留甲状腺组织进行了消融治疗,甲状腺球蛋白水平正常。经过12年的病程,患者出现胸痛和呼吸困难,CT图像显示右肺底部可疑转移灶。甲状腺球蛋白水平升高,而131I扫描为阴性。为排除其恶性病变的转移,进行了全身PET-FDG检查,结果显示脑、小脑、颈部、胸部、淋巴结和骨骼有多个高FDG摄取灶,提示疾病去分化。这些发现随后在临床病程中得到证实。因此,全身PET-FDG是对131I扫描阴性且甲状腺球蛋白水平升高的甲状腺分化型癌(CDT)患者进行研究的一种补充诊断技术。