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Thyroid incidentalomas are occasionally found in patients with head and neck cancer
The background of the study. Many patients with head and neck cancer undergo positron emission tomography (PET) using radioactively labeled fluorodeoxyglucose (FDG) for staging and monitoring of their cancer, which may reveal thyroid uptake of FDG. In this study, the frequency and causes of abnormal thyroid uptake of FDG were determined in patients with head and neck cancer.
How the study was done. The study subjects were 689 patients (182 women, 507 men; mean age, 57 years) with head and neck cancer who underwent FDG-PET imaging before any treatment. Patients with focal thyroid abnormalities underwent ultrasound- or palpation-guided fine-needle aspiration biopsy of the nodule.
The results of the study. Nineteen of the 689 patients (3 percent) had incidental focal thyroid uptake of FDG. Twelve patients were studied further, 4 refused further study and 3 did not return for more studies. Eight of the 12 patients had a squamous-cell carcinoma of the head or neck and 1 each had other tumors in the same region.
The thyroid nodules ranged from 0.6 to 3.5 cm in longest dimension. The biopsy diagnosis was suspicious for papillary carcinoma in four patients; all proved to have papillary carcinoma. The cytologic diagnosis was follicular tumor in four; at surgery, two proved to have a follicular adenoma, one a Hürthle-cell adenoma, and one a follicular carcinoma. In the remaining four patients, the biopsy diagnosis was hyperplastic nodule; they did not undergo thyroid surgery. Overall, 5 of the 12 patients (42 percent) had a thyroid carcinoma.
The conclusions of the study. Some patients with head and neck cancer have incidental thyroid nodules, as detected by FDG-PET imaging, nearly half of which are thyroid carcinomas.
The original article. Nam SY, Roh JL, Kim JS, Lee JH, Choi SH, Kim SY. Focal uptake of 18F-fluorodeoxyglucose by thyroid in patients with nonthyroidal head and neck cancers. Clin Endocrinol (Oxf) 2007;67:135-9.
 Next Article: Few patients with thyroid nodules have high serum calcitonin concentrations indicative of medullary thyroid cancer |
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