From the *Department of Radiology, †Department of Otolaryngology, ‡Harold C. Simmons Comprehensive Cancer Center, and §Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX.
Clin Nucl Med. 2015 Aug;40(8):689-91. doi: 10.1097/RLU.0000000000000788.
A 30-year-old man had a diagnosis of aggressive carcinoma showing thymuslike differentiation (CASTLE disease) and underwent thyroidectomy for tumor resection and bilateral cervical lymph node dissection. Multiple hypermetabolic nodal metastases were detected in the neck and upper mediastinum with fluorine-18-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography ((18)F-FDG PET/CT). The patient received radiation therapy and chemotherapy for treatment of metastases. Follow-up (18)F-FDG PET/CT demonstrated resolution of several hypermetabolic lesions previously seen in the neck, but innumerable new hypermetabolic metastatic lesions were visualized. The patient died of this aggressive CASTLE disease despite treatment with surgery, radiation, and systemic chemotherapy.
一位 30 岁男性被诊断为具有胸腺样分化的侵袭性癌（CASTLE 病），并接受了甲状腺切除术以进行肿瘤切除和双侧颈淋巴结清扫。氟-18-氟代-2-脱氧-D-葡萄糖正电子发射断层扫描/计算机断层扫描（(18)F-FDG PET/CT）显示颈部和上纵隔有多发性高代谢淋巴结转移。患者接受了颈部转移灶的放疗和化疗。随访（18）F-FDG PET/CT 显示颈部先前可见的多个高代谢病变已消退，但发现无数新的高代谢转移性病变。尽管进行了手术、放疗和全身化疗，该侵袭性 CASTLE 病患者仍死亡。
