Seiji Sugano

Thallium‐201‐chloride thyroid scintigraphy to evaluate benign and/or malignant nodules usefulness of the delayed scan

The purpose of this study is to evaluate benign and/or malignant thyroid tumors with 201TI thyroid scan. We studied 76 cases of histologically verified thyroid tumors, all seen as cold nodules on the 123I thyroid scan. 201TI thyroid scan was performed 5–15 minutes (early scan) and 3–5 hours (delayed scan) after intrayenous administration of 1.5–2.0 mCi of 201TI. In 35 (94.6%) of 37 malignant tumors (anaplastic carcinoma, six; papillary carcinoma, 23; follicullar carcinoma, five; epidermoid carcinoma, one; malignant lymphoma, 1), 201TI accumulated in the cold nodule of the 123I thyroid scan on both early and delayed scans. On the other hand, the delayed 201TI scan was negative in 35 out of 39 (89.7%) benign tumors. Employing early and delayed 201TI scans, we were able to differentiate most malignant thyroid tumors from those which were benign. False‐negative and ‐positive cases are discussed.

Mucoepidermoid Carcinoma of the Pancreas : Report of a Case

We present herein the case of a 64-year-old man diagnosed as having a mucoepidermoid carcinoma of the pancreas. The tumor originated in the tail of the pancreas and invaded the spleen, left adrenal gland, left kidney, and transverse colon. Liver and peritoneal metastases were also noted. Despite surgical treatment and adjuvant chemotherapy, the disease progressed rapidly and the patient died of cachexia 4 months after his initial diagnosis. Mucoepidermoid carcinoma of the pancreas is a rare entity, and is believed to be a form of adenosquamous carcinoma known as adenoacanthoma. However, in this patient, no differentiated squamous cell component could be detected. In fact, the tumor was composed of mucin-producing cells, epidermoid cells, and intermediate cells. Immunohistochemical staining for the carcinoembryonic antigen, CA19-9, and SPan-1 demonstrated a production of cancerous mucin in the epidermoid cells, suggesting that mucoepidermoid carcinoma may arise from the squamoid metaplasia of an adenocarcinoma.