Pulmonary mucoepidermoid carcinoma in children: a rare diagnosis not to be overlooked - case report.

Pulmonary mucoepidermoid carcinoma (PMEC) in children is a rare entity. The diagnosis is often unrecognized, often treated as pneumonia, a more frequent diagnosis at this age. Case presentation: The authors report in this article, the case of a 12-year-old child with a clinical history of chronic cough evolving for 6 months with recurrent episodes of pneumonia. The presence of a foreign body was suggested on the thoracic computed tomography (CT). PMEC was histopathologically determined on biopsy. Fluorine-18-fluorodesoxyglucose positron emission tomography (18 F-FDG PET)/CT was performed as part of the extension work-up prior to surgical management. Clinical discussion: Preoperative imaging with 18F-FDG PET/CT seems to be a valuable tool for predicting tumor grade, nodal stage, and postsurgical prognosis in mucoepidermoid carcinoma. PMEC patients with high 18F-FDG PET/CT uptake may need extensive mediastinal lymph node dissection and adjuvant therapy. Conclusion: PMEC has different presentations depending on the degree of tumor differentiation on PET/CT whose input in the management of these rare cancers requires further studies.

An unusual presentation of papillary thyroid carcinoma: a case report.

INTRODUCTION: Parathyroid carcinoma (PC) is exceptional cause of primary hyperparathyroidism (PHPT). It has an estimated prevalence of 0.3 to 5.6% and is rarely associated with non-medullary thyroid cancer. OBSERVATION: We report a case of parathyroid carcinoma resulting in a hyperparathyroidism and revealing a papillary thyroid carcinoma and emphasize on the management particularities of this entity. A 37-year-old woman, with prolactin secreting pituitary microadenoma, presented with asthenia and bone pain. Laboratory findings were consistent with PHPT. Neck ultrasonography showed a 3 cm nodule adjacent to the right thyroid lobe with no abnormalities in the thyroid gland. Parathyroid scintigraphy showed a right inferior parathyroid adenoma. Because of the patient age and the decreased renal function, surgical treatment was required. During the intra-operative neck exploration, a juxta-thyroid tumoral right mass was strongly adherent to the right infra-hyoid muscle and the recurrent laryngeal nerve. The frozen examination of the mass demonstrated malignancy features suggesting a poorly differentiated thyroid carcinoma. Thus, a total thyroidectomy with bilateral central neck dissection was carried out. Final histopathological examination showed a 3.5 cm PC infiltrating the thyroid gland with a papillary thyroid microcarcinoma of the left thyroid lobe. External radiotherapy of the neck, indicated for PC, was performed 1 month after surgery. A radioactive iodine therapy was used 6 months postoperatively. CONCLUSION: Despite its rarity, PC is to bear in mind in case of PHPT. The association between PC and differentiated thyroid carcinoma is not to be ignored.

Single-Photon Emission Computed Tomography for Preclinical Assessment of Thyroid Radioiodide Uptake Following Various Combinations of Preparative Measures.

BACKGROUND: MicroSPECT/CT imaging was used to quantitatively evaluate how iodide uptake in the mouse thyroid is influenced by (i) route of iodine administration; (ii) injection of recombinant human thyrotropin (rhTSH); and (iii) low iodide diet (LID) in euthyroid and triiodothyronine (T3)-treated mice. METHODS: Pertechnetate (99mTcO4-) and 123I thyroid uptake in euthyroid and T3-treated animals fed either a normal-iodine diet (NID) or an LID, treated or not with rhTSH, and radiotracer administered intravenously, subcutaneously, intraperitoneally or by gavage, were assessed using microSPECT/CT imaging. Western blotting was performed to measure sodium/iodide symporter expression levels in the thyroid. RESULTS: Systemic administration of radioiodide resulted in a higher (2.35-fold in NID mice) accumulation of iodide in the thyroid than oral administration. Mice fed LID with systemic radioiodide administration showed a further two-fold increase in thyroid iodide uptake to yield a ∼5-fold increase in uptake compared to the standard NID/oral route. Although rhTSH injections stimulated thyroid activity in both euthyroid and T3-treated mice fed the NID, uptake levels for T3-treated mice remained low compared with those for the euthyroid mice. Combining LID and rhTSH in T3-treated mice resulted in a 2.8-fold higher uptake compared with NID/T3/rhTSH mice and helped restore thyroid activity to levels equivalent to those of euthyroid animals. CONCLUSIONS: Systemic radioiodide administration results in higher thyroidal iodide levels than oral administration, particularly in LID-fed mice. These data highlight the importance of LID, both in euthyroid and T3-treated, rhTSH-injected mice. Extrapolated to human patients, and in the context of clinical guidelines for the preparation of differentiated thyroid cancer patients, our data indicate that LID can potentiate the efficacy of rhTSH treatment in T3-treated patients.