open access

Vol 6, No 2 (2003)
Short communications
Published online: 2003-10-10
Submitted: 2012-01-23
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Columnar cell thyroid carcinoma - diagnostic dilemmas and pitfalls

Ivana Žagar, Barbara Vidergar-Kralj, Andreja A. Schwarzbartl-Pevec, Franc Pompe
Nucl. Med. Rev 2003;6(2):155-158.

open access

Vol 6, No 2 (2003)
Short communications
Published online: 2003-10-10
Submitted: 2012-01-23

Abstract

BACKGROUND: Columnar cell carcinoma is a rare variant of papillary thyroid carcinoma associated with aggressive clinical behaviour.
A CASE REPORT: of a 34-year-old male patient, who presented withe rapidly growing mass in the neck, extending to the anterior and middle mediastinum, tightly closing the upper thoracic apperture and causing tracheal and oesophageal deviation, with minimal compression and stenosis. A diagnosis of columnar cell carcinoma, arising from the ectopic thyroid tissue just adjacent to the left thyroid lobe was based on histological and intraoperative findings. Near total thyroidectomy and lymph-node dissection were followed by external beam radiotherapy of the neck and mediastinum, chemotherapy and radioiodine ablation of the remaining functional thyroid tissue. Pre-and post-operative radionuclide imaging (99mTc(V)-DMSA, 99mTc-MIBI, 123-I-mIBG and Octreoscanr) findings are discussed, with a special emphasis given to the dilemmas in histological characterisation of the tumor, the problems in therapeutic approach and the dilemmas and pitfalls in the interpretation of radionuclide findings in this patient, especially the ones performed post radiotherapy of the neck and mediastinum.

Abstract

BACKGROUND: Columnar cell carcinoma is a rare variant of papillary thyroid carcinoma associated with aggressive clinical behaviour.
A CASE REPORT: of a 34-year-old male patient, who presented withe rapidly growing mass in the neck, extending to the anterior and middle mediastinum, tightly closing the upper thoracic apperture and causing tracheal and oesophageal deviation, with minimal compression and stenosis. A diagnosis of columnar cell carcinoma, arising from the ectopic thyroid tissue just adjacent to the left thyroid lobe was based on histological and intraoperative findings. Near total thyroidectomy and lymph-node dissection were followed by external beam radiotherapy of the neck and mediastinum, chemotherapy and radioiodine ablation of the remaining functional thyroid tissue. Pre-and post-operative radionuclide imaging (99mTc(V)-DMSA, 99mTc-MIBI, 123-I-mIBG and Octreoscanr) findings are discussed, with a special emphasis given to the dilemmas in histological characterisation of the tumor, the problems in therapeutic approach and the dilemmas and pitfalls in the interpretation of radionuclide findings in this patient, especially the ones performed post radiotherapy of the neck and mediastinum.
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Keywords

columnar cell thyroid carcinoma; therapy; radionuclide imaging; interpretation pitfalls

About this article
Title

Columnar cell thyroid carcinoma - diagnostic dilemmas and pitfalls

Journal

Nuclear Medicine Review

Issue

Vol 6, No 2 (2003)

Pages

155-158

Published online

2003-10-10

Bibliographic record

Nucl. Med. Rev 2003;6(2):155-158.

Keywords

columnar cell thyroid carcinoma
therapy
radionuclide imaging
interpretation pitfalls

Authors

Ivana Žagar
Barbara Vidergar-Kralj
Andreja A. Schwarzbartl-Pevec
Franc Pompe

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