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A Cardiac Metastasis of Follicular Thyroid Carcinoma With Partly Squamous Cell Differentiation

Detection in FDG-PET Preceded Visibility on Echocardiography and MRI by More Than a Year

Stegger, Lars, MD, PhD*; Rahbar, Kambiz, MD*; Schülke, Christoph, MD; Huss, Sebastian, MD; Wenning, Christian, MD*

doi: 10.1097/RLU.0000000000002297
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PET using the radiotracer 18F-fluorodeoxyglucose (FDG) was performed in a patient who presented with elevated thyroglobulin (Tg) levels several years after initial therapy of follicular thyroid carcinoma (oncocytic variant) and in whom high-dose radioiodine (131I) failed to locate recurrent tumor or to decrease Tg levels. A focal fluorodeoxyglucose uptake in the apical septum of the heart did not have a discernible correlate in echocardiography or MRI for more than 12 months. Finally, a metastasis of the follicular thyroid carcinoma with partly squamous cell differentiation was confirmed and treated by resection and stereotactic body radiotherapy.

From the Departments of *Nuclear Medicine,

Radiology, and

Pathology, University Hospital Münster, Münster, Germany.

Received for publication July 4, 2018; revision accepted August 23, 2018.

Conflicts of interest and sources of funding: none declared.

Correspondence to: Lars Stegger, MD, PhD, Department of Nuclear Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany. E-mail: stegger@uni-muenster.de.

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