title: Detection of Widespread Metastasis in a Case of Aggressive Carcinoma Showing Thymuslike Differentiation (CASTLE Disease) Using 18F-FDG PET/CT.
abstract: A 30-year-old man had a diagnosis of aggressive carcinoma showing thymuslike differentiation (CASTLE disease) and underwent thyroidectomy for tumor resection and bilateral cervical lymph node dissection. Multiple hypermetabolic nodal metastases were detected in the neck and upper mediastinum with fluorine-18-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography ((18)F-FDG PET/CT). The patient received radiation therapy and chemotherapy for treatment of metastases. Follow-up (18)F-FDG PET/CT demonstrated resolution of several hypermetabolic lesions previously seen in the neck, but innumerable new hypermetabolic metastatic lesions were visualized. The patient died of this aggressive CASTLE disease despite treatment with surgery, radiation, and systemic chemotherapy.
authors.affiliation: From the *Department of Radiology, †Department of Otolaryngology, ‡Harold C. Simmons Comprehensive Cancer Center, and §Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: Ikponmwosa
authors.initials: I
authors.lastname: Iyamu
authors.forename: Jason
authors.initials: J
authors.lastname: Wachsmann
authors.forename: John
authors.initials: J
authors.lastname: Truelson
authors.forename: Dana
authors.initials: D
authors.lastname: Mathews
authors.forename: Fangyu
authors.initials: F
authors.lastname: Peng
mesh_terms: D000328:Adult; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000473:pathology; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18