FDG PET/CT in the detection of pancreatic metastasis in a patient with follicular thyroid carcinoma and negative I-131 whole body scan findings

Radioiodine Retention Within Dilated Common Biliary Duct Mimicking Metastatic Thyroid Cancer Diagnosed by the Combination of SPECT/CT and MRI

A 55-year-old woman with papillary thyroid carcinoma under total thyroidectomy and cervical lymph node dissection was referred for I radioiodine therapy. Posttherapeutic whole-body scintigraphy revealed increased focal uptake in the right upper abdomen, which localized to the region of the head of the pancreas on SPECT/CT fusion images. Further evaluation with MRI affirmed the radioiodine retention corresponded to bile duct dilation.

Long-Term Outcomes After Hepatic and Pancreatic Resections for Metastases from Thyroid Cancer: a Systematic Review of the Literature

PURPOSE

The objective of our systematic review was to evaluate the long-term outcomes of surgical resection as a treatment strategy for liver and pancreatic metastases from thyroid cancer (TC).

METHODS

A systematic search of three electronic databases for articles published up to October 2018 was conducted. All appropriate observational studies and case reports which reported outcomes from patients with TC metastatic to the liver or pancreas were considered eligible for inclusion in the present systematic review.

RESULTS

A total of 15 studies, which comprised of 16 patients that underwent hepatic or pancreatic resection for TC metastasis, were included in the present systematic review; among them, 5 presented with metastasis to the liver, whereas 11 had pancreatic metastatic disease. The median time interval between the initial thyroidectomy and the diagnosis of metastases (either hepatic or pancreatic) was 60 months (SE 23.8, 95% CI 13.3-106.7) for the entire cohort and the mean overall survival was 37.6 months (SE 8, 95% CI 22-53.3). Five patients with pancreatic metastases presented with recurrence whereas no recurrences were noted in patients with liver metastases.

CONCLUSIONS

Surgical resection of liver and pancreatic metastases from TC seems to be a safe and efficient treatment option for selected patients. In that setting, long-term outcomes in patients with resected TCLM are encouraging given the absence of recurrence as reported from the included studies, whereas in the case of TCPM, survival is limited due to advanced disease at diagnosis and recurrence rates.

Primary squamous cell carcinoma of the pancreas with effective comprehensive treatment: A case report and literature review

RATIONALE

Primary squamous cell carcinoma (SCC) of the pancreas is a rare entity since the pancreas lacks squamous cells. This condition is associated with a poor prognosis, and there is currently no optimal treatment strategy for it.

PATIENT CONCERNS

A 64-year-old female patient with a complaint of epigastric pain for 3 months was referred to our hospital.

DIAGNOSES

She was finally diagnosed with primary SCC of the pancreas with lymph node metastasis on the basis of radiological and pathological findings.

INTERVENTIONS

She received chemoradiation along with targeted therapy and was provided with treatment response evaluation through PET/CT.

OUTCOMES

She eventually died of tumor progression after 8 months.

LESSONS

Primary SCC of the pancreas is associated with a poor prognosis. Comprehensive therapy and proper radiologic evaluation may facilitate prolonged survival of these patients.

Pancreatic metastasis of papillary thyroid carcinoma preoperatively diagnosed by endoscopic ultrasound-guided fine-needle aspiration biopsy: a case report with review of literatures

Pancreatic metastatic tumors from thyroid carcinoma are extremely rare. We report a case of an 80-year-old female with a pancreatic metastatic tumor derived from papillary thyroid carcinoma which was initially resected 158 months prior to detection of the metastatic pancreatic tumor. The patient has encountered cervical lymph-node metastasis on three occasions following the initial operation. Metastatic pancreatic lesions and cervical lymph nodes were first detected using 18-fluorodeoxyglucose positron-emission tomography/computed tomography, and she was preoperatively diagnosed using endoscopic ultrasound-guided fine-needle aspiration biopsy. A coin lesion, 10 mm in size, was detected in the left lung by chest computed tomography with no abnormal uptake in 18-fluorodeoxyglucose positron-emission tomography/computed tomography. Distal pancreatectomy and cervical lymph-node dissection were performed. Adjuvant chemotherapy with weekly paclitaxel was administered because anaplastic transformation had been detected in one of the cervical lymph nodes. The patient eventually died from multiple lung metastases 11 months after removing the metastatic pancreatic lesion. We reported a rare case of a pancreatic metastatic tumor from thyroid carcinoma, and found that 18-fluorodeoxyglucose positron-emission tomography/computed tomography and endoscopic ultrasound-guided fine-needle aspiration biopsy are useful for preoperatively diagnosing tumors.