Nam Soon Yuhl, Roh Jong-Lyel, Kim Jae Seung, Lee Jeong Hyun, Choi Seung-Ho, Kim Sang Yoon
Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Clin Endocrinol (Oxf). 2007 Jul;67(1):135-9. doi: 10.1111/j.1365-2265.2007.02850.x. Epub 2007 Apr 27.
To evaluate the prevalence and significance of focal thyroid lesions identified by (18)F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) in patients with nonthyroidal head and neck cancers (HNC).
Patients with histologically identified HNC who underwent FDG-PET and computed tomography (CT) were reviewed retrospectively. We evaluated the prevalence of patients with focal thyroid FDG uptake and the risk of malignancy and proper management in these patients.
Of 689 HNC patients, 19 (2.8%) had focal thyroid FDG uptake. Of the 12 patients with a histological diagnosis by surgery or needle biopsy, 5 (41.7%) had carcinomas, 4 papillary and 1 follicular, whereas the others had benign thyroid lesions. The maximum standardized uptake value on PET was not sufficient to discriminate between malignant and benign thyroid lesions (8.4 +/- 13.2 vs. 4.2 +/- 4.0; P > 0.4). The identification of incidental thyroid diseases helped guide patient counselling and combined surgery with HNC and thyroidectomy.
Focal thyroid lesions incidentally found on FDG-PET in patents with nonthyroidal HNC have a high probability of malignancy. These lesions deserve further diagnostic examination before HNC treatment to ensure adequate therapy for incidental thyroid cancers.
评估¹⁸F-氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）在非甲状腺头颈部癌（HNC）患者中发现的局灶性甲状腺病变的患病率及意义。
对经组织学确诊为HNC且接受了FDG-PET和计算机断层扫描（CT）的患者进行回顾性分析。我们评估了局灶性甲状腺FDG摄取患者的患病率、恶性风险以及这些患者的合理管理。
在689例HNC患者中，19例（2.8%）有局灶性甲状腺FDG摄取。在12例经手术或针吸活检获得组织学诊断的患者中，5例（41.7%）为癌，4例乳头状癌和1例滤泡状癌，其余为良性甲状腺病变。PET上的最大标准化摄取值不足以区分甲状腺恶性和良性病变（8.4±13.2对4.2±4.0；P>0.4）。偶然发现的甲状腺疾病有助于指导患者咨询以及HNC联合手术和甲状腺切除术。
在非甲状腺HNC患者的FDG-PET上偶然发现的局灶性甲状腺病变有很高的恶性可能性。在HNC治疗前，这些病变值得进一步的诊断检查，以确保对偶然发现的甲状腺癌进行充分治疗。
