Concluded Case

Papillary Thyroid carcinoma with bilateral diffuse pulmonary metastasi

A 65 years old female with a a thyroid mass sonce last 6 months. Her thyroid profile is normal - although on L- Thyroxine 50 mcg for hypothyroidism A CECT neck shoes a large right thyroid lobe mass with bilateral cervical lymphadenopathy With bilateral diffuse pulmonary metastasis . F.N.A.C - Papillary Carcinoma of thyroid PET scan - Thyroidal malignant neoplasm with bilateral cervical level 3 to 5 lymph node involvement- non - FDG Avid . Extensive FDG avid and variable sized nodular lesions in all lobes of both lungs . Treatment- Options in this case welcomed

LikeAnswersShare
Concluded answer

Papillary carcinoma of thyroid is a treatable carcinoma, but unfortunately the case presented is advanced one.For local management total Thyroidectomy and radical dissection of the neck for lymphadenopathy.As suggested by Dr Tara Chand, isotope scan of radio iodine and radio iodine treatment which will take care of primary and secondaries.Few chemotherapeutic drugs also available and tried.

All Answers

Primary thyroid malignancy and it's metastasis to lungs are FDG avid Cervical lymph nodes are not FDG avid, they could represent reactive lymphadenopathy Plan Serum B thyroglobulin level Total thyroidectomy Radical neck dissection thyroid scan to see if metastatic lesion are taking up iodine, is they are taking up iodine then radioactive iodine treatment can be planned if lesions are not taking to iodine then Palliative chemotherapy

Valuable opinion
0

Total thyroidectomy with lymph node dissection followed by radio iodine scan and radioiodine therapy and then observation. Follow up with thyroglobulin

Papillary carcinoma of thyroid is a treatable carcinoma, but unfortunately the case presented is advanced one.For local management total Thyroidectomy and radical dissection of the neck for lymphadenopathy.As suggested by Dr Tara Chand, isotope scan of radio iodine and radio iodine treatment which will take care of primary and secondaries.Few chemotherapeutic drugs also available and tried.

Its a secondary to pulmonary (metastasis).. Secondary involved should be removed along with nearest lymmph node. Follow up chemo threpy ...I-131 & ..external beam with hormonal therapy for couple of months.

Papillary carcinoma do pet scan oncosurgeon remove thyroid mass with nearest lymph nodes where spread possible then chemotherapy harmone therapy with 6 monthly follow up

Valuable opinion
0

I 131 Radiation therapy External beam radiation After a interval, total thyroidectomy with cervical lymph node resection can be considered.

Thank you doctor
0

Total thyroidectomy with bilateral neck dissection followed by radio iodine evaluation and treatment

Although radiotherapy is indicated but Oncologist can better opine

Thank you doctor
0

Do PET, PROPER STAGING, PALLIATIVE RADIOTHERAPY OR CHEMO

Cases that would interest you