Medullary thyroid carcinoma with metastases

Case contributed by Francis Fortin
Diagnosis certain

Presentation

Dyspnea, stridor, neck mass

Patient Data

Age: 65 years
Gender: Female
This study is a stack
Axial C+
delayed
This study is a stack
Axial bone
window
This study is a stack
Coronal
non-contrast
This study is a stack
Sagittal
C+ delayed
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Info

Large right thyroid and superior mediastinal mass causing infraglottic tracheal stenosis. Countless cervical lymphadenopathy which are hyperenhancing (on C+ scan) with mottled punctate hyperdensities likely representing microcalcifications (on coronal C- scan). The lymph nodes are of similar appearance to the thyroid gland, which also contains some coarse calcifications. Lytic bone lesion involving the left anterolateral T2 vertebra with a soft tissue component.

Ultrasound-guided biopsy

ultrasound
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Info

Biopsy of a station 6 lymph node with punctate hyperechogenic foci.

Nuclear medicine
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Info

Hypermetabolic thyroid mass with countless cervical adenopathy and multiple bone lesions.

Case Discussion

Biopsy proven case of metastatic medullary thyroid carcinoma.

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