FDG Uptake in Metastatic Spreading Mucoepidermoid Carcinoma of the Thyroid

Department of Nuclear Medicine, University Hospital of Berne (Inselspital), Berne, Switzerland.
Clinical Nuclear Medicine (Impact Factor: 3.93). 06/2007; 32(5):383-7. DOI: 10.1097/01.rlu.0000259655.75971.28
Source: PubMed
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    ABSTRACT: Clinical and morphological features of three cases of primary mucoepidermoid carcinoma of the thyroid are described. The tumours were composed of two cell types. One of these resembled squamous epithelium and ultrastructurally showed tonofilaments and numerous desmosomes. The other cell type contained Alcian blue and mucicarmine positive mucin and, on electron microscopy, showed mucigen granules. Marked stromal fibrosis and psammoma bodies were seen in all tumours. Immunohistochemical studies showed that the tumour cells were negative for thyroglobulin. A few calcitonin-containing cells were seen in one metastatic tumour. One tumour showed, in addition to the histological features of mucoepidermoid carcinoma, anaplastic areas with obvious transition between the two histological patterns. The same thyroid also had a small thyroglobulin-positive papillary carcinoma in the opposite lobe. All tumours presented lymph node metastases. In two cases the primary tumour was confined within the thyroid capsule but that with anaplastic areas invaded surrounding structures. This patient died 13 months after diagnosis; the other patients are alive and symptomless one and 10 years since diagnosis. Mucoepidermoid carcinoma of the thyroid appears to be a clinicopathological entity that resembles papillary carcinoma in its natural history. The origin of the tumour is unclear. There is, however, some histological and immunohistological data suggesting that the tumour might be related to the ultimobranchial system although some histological features also appear to favour a common origin with papillary carcinoma.
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    ABSTRACT: A 20-year-old euthyroid white woman presented with two palpable thyroid nodules. The scintiscan showed an area of increased uptake in the isthmus corresponding with one of the palpable nodules. The uptake in the rest of the gland was diminished including the area of the second palpable nodule which was in the superior portion of the left lobe. Microscopic examination revealed diffuse lymphocytic thyroiditis, follicular adenoma and the isthmus and mucoepidermoid carcinoma of the upper left lobe. No primary site for the muceopidermoid carcinoma outside the thyroid has been identified. Mucoepidermoid carcinoma of the thyroid gland has not previously been reported; the literature is briefly reviewed and etiologic considerations are discussed.
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