Fortuitous discovery of non-fluorocholine-fixing papillary carcinoma of vesicular variant of the thyroid

Abstract

PurposeCharacterization of thyroid nodules is crucial to propose surgical intervention for histological verification. Cervical ultrasound potentially combined with fine needle aspiration is recommended, and fluorocholine positron emission tomography (FCH-PET), commonly used in prostatic cancers, has been evaluated in the diagnosis of thyroid cancers in recent publications.MethodsWe present two cases of patients with multinodular thyroid and primary hyperparathyroidism. The preoperative assessment consisted of an ultrasound, a MIBI scintigraphy and an FCH-PET in favor of a parathyroid adenoma.ResultsThe imaging examinations pointed to a diagnosis of a parathyroid adenoma. In both cases, papillary thyroid carcinoma, missed by FCH-PET, was discovered incidentally at a distance from the parathyroid adenoma during the surgical procedure.ConclusionsThese are the first descriptions of thyroid papillary carcinoma without preoperative FCH-PET identification. These clinical cases are contrary to recent publications showing a benefit of this examination in the diagnosis of thyroid cancers.