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Histological Aggressiveness of Fluorodeoxyglucose Positron-Emission Tomogram (FDG-PET)-Detected Incidental Thyroid Carcinomas

  • Original Papers
  • Head and Neck Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

We previously reported a high incidence of primary thyroid cancer in fluorodeoxyglucose positron-emission tomogram (FDG-PET)-detected incidental thyroid abnormalities. The aim of our study was to determine if these FDG-PET-detected thyroid malignancies represent a more-aggressive variant of primary thyroid carcinoma.

Materials and methods

All patients that underwent operative intervention for FDG-PET-detected incidental thyroid abnormalities were identified (June 2003 to April 2006). Patients with a diagnosis of primary thyroid carcinoma on final histopathology were included in the study. The patient demographics and histopathological findings were analyzed to identify adverse prognostic features.

Results

In 11,500 patients, 17,250 FDG-PET scans were performed; 377 of these patients (3.2% of patients and 2.1% of FDG-PET scans) had findings positive for thyroid abnormality. Of the 32 patients that underwent operative intervention, 22 patients with a final diagnosis of primary thyroid malignancy were included in the study. A greater number of patients [12 patients, (54%)] were noted to harbor poor prognostic variants of primary thyroid carcinoma on final histopathology [tall-cell variant: 11 patients (50%) and poorly differentiated thyroid carcinoma: 1 patient (4%)]. Extra-thyroidal extension (ETE) was noted in the majority of patients [14 patients (63%)]. In patients with tall cell variant on final histopathology, the rate of ETE was even higher [10 patients (90%)].

Conclusion

Thyroid malignancies incidentally detected on FDG-PET scan harbor a high rate of unfavorable prognostic features and may represent a more-aggressive variant of primary thyroid carcinoma. These patients need to be subjected to further investigation with a view to possible operative intervention.

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Authors and Affiliations

  1. Division of Surgical Oncology, Department of Surgery, Eppley Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA

    Chandrakanth Are MD

  2. Department of Surgery, Wyckoff Heights Medical Center, Brooklyn, NY, USA

    John F. Hsu DO

  3. Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Ronald A. Ghossein MD

  4. Department of Radiology, Nuclear Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Heiko Schoder MD

  5. Department of Head and Neck Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Jatin P. Shah MD & Ashok R. Shaha MD

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  1. Chandrakanth Are MD
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  2. John F. Hsu DO
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  3. Ronald A. Ghossein MD
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  4. Heiko Schoder MD
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  5. Jatin P. Shah MD
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  6. Ashok R. Shaha MD
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Correspondence to Chandrakanth Are MD.

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Are, C., Hsu, J.F., Ghossein, R.A. et al. Histological Aggressiveness of Fluorodeoxyglucose Positron-Emission Tomogram (FDG-PET)-Detected Incidental Thyroid Carcinomas. Ann Surg Oncol 14, 3210–3215 (2007). https://doi.org/10.1245/s10434-007-9531-4

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  • DOI: https://doi.org/10.1245/s10434-007-9531-4

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