Case 30. (25 May 1998)
Diagnosis: Miliary metastasis from Thyroid cancer
CT of case 30
Papillary Carcinoma of thyroid is
occured in 60% (20% follicular, 15% anaplastic, 1-5% medullary carcinoma)
of all thyroid carcinomas, metastasize to regional lymph nodes in 40%,
hematogenous to lung in 4%(early spread to lung and bone in follicular
carcinoma). In papillary carcinoma, tumor usually concentrates radioiodine,
but in follicular carcinoma, tumor usually concentrates pertechnetate.
Of 731 patients with papillary thyroid
cancer, 91 had metastases outside regional lymph nodes. The most common
site was intrathoracic, occurring in 73 of the 91 patients. Miliary, micronodular
pulmonary metastases, with iodine 131 (I-131) uptake and "curable" by I-131
treatment were encountered in 7 patients. (Hoie J, et. al. Cancer;1988(61)1-6
)
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