PMC6076977_01
Surgical pathology of the right clavicular mass revealing metastatic papillary adenocarcinoma.
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A fine needle aspiration of the mass was performed; histology showed papillary thyroid carcinoma [Figure 1].
Coronal-fused 18F-FDG PET/CT shows FDG avid lesion in the distal right clavicle with osseous destruction and an FDG avid mediastinal mass displacing the trachea to the left.
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The thyroid gland was small and atrophic [Figure 2].
Axial chest CT showing a hypodense, solid, infrahyoid mass extending to the superior mediastinum.
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Postsurgery CT scan showed a hypodense, solid, infrahyoid mass extending to the superior mediastinum with surrounding adenopathy [Figure 3].
Pathology report of central neck biopsy of superior mediastinal mass revealing papillary thyroid carcinoma.
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The biopsy reported papillary carcinoma, with similar cellular characteristics as that reported in the clavicular mass; surgical pathology report revealed papillary thyroid carcinoma with tumor cells positive for TTF-1 and focally positive for thyroglobulin [Figure 4].
Left: posttherapy 131-iodine WBS shows no evidence of functional thyroid tissue. Right: coronal-fused images of 18F-FDG PET/CT study performed after posttherapy WBS show the FDG avid mediastinal and right shoulder masses.
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fig5
Follow-up PET/CT performed with 15 mCi [555 MBq] of 18F-FDG showed the previously described mediastinal FDG avid mass, with a cystic or necrotic area, development of hypermetabolic neck lymph nodes, axillary nodes, and pulmonary nodes and a large mass in the right shoulder area [SUV max: 5.5] [Figure 5].