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Vol.55 No.2 contents | Japanese/English |
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- Case Report -
A Case of Papillary Carcinoma Located in the Superior Mediastinum Suspected to Be Metastasis of Occult Thyroid Carcinoma
Akira Naomi1, Hironori Oyamatsu2, Kunio Narita2, Masato Nakayama3, Shouki Maeda41Department of Thoracic Surgery, Aichi Cancer Center Hospital, Japan, 2Department of Respiratory Surgery, 3Department of Cardiovascular Surgery, 4Department of Pathology, Toyohashi Municipal Hospital, Japan
Background. Many cases of thyroid carcinoma with detected metastatic sites have been reported; however, solitary metastasis of thyroid carcinoma to the mediastinum is rare. Case. A 51-year-old man underwent a checkup during cancer screening with CT, which showed a solitary nodule in the superior mediastinum. Four years after the first screening, positron emission tomography with 18F-fluorodeoxyglucose (FDG)-PET revealed increased FDG uptake in the tumor in the late phase. The patient was referred to our hospital. We suspected metastasis of cancer or ectopic thymoma, etc. and subsequently performed tumorectomy via a skin incision near the superior margin of the sternum. The nodule demonstrated an oval shape and had a smooth margin with no invasive characteristics; therefore, it was not difficult to exfoliate. A histological examination revealed thyroid papillary carcinoma, although no nodules in the thyroid were detected using CT, magnetic resonance imaging (MRI) or ultrasonography before the operation. We were not able to identify continuity from the thyroid to the nodule. Hence, we diagnosed the lesions as solitary metastasis of occult thyroid carcinoma. Conclusions. In this case, we highly suspected solitary metastasis of occult thyroid carcinoma; however, it was difficult to distinguish the lesion from ectopic thyroid carcinoma. Therefore, careful follow-up is required.
key words: Occult thyroid carcinoma, Ectopic thyroid carcinoma, Solitary metastasis in the mediastinum, Papillary thyroid carcinoma in the superior mediastinum
Received: September 18, 2014
Accepted: March 13, 2015
JJLC 55 (2): 98-101, 2015
