title: Aggressive Disease Course of Papillary Thyroid Carcinoma with Focal Undifferentiated Component: A Case Report.
abstract: We report an aggressive papillary thyroid carcinoma (PTC) with focal undifferentiated component in a 32-year-old female. She had limited disease confined within the thyroid gland at diagnosis. Within 12 months of thyroidectomy and radioiodine ablation, thyroglobulin (Tg) levels were elevated. Second radioiodine ablative dose was given, however, stimulated Tg levels showed an upward trend with negative iodine scan within 12 months. An 18F fludeoxyglucose-avid solitary pulmonary nodule that was detected on positron emission tomography/computed tomography scan was resected followed by empiric radioiodine therapy. Within the next 10 months she developed multifocal bone metastases. The multifocal disease was rendered inoperable and treated with external beam radiation. The patient is on follow-up, and the Tg level continues to rise with local disease progression. In a small percentage of patients, PTC behaves as a very aggressive disease despite treatment. Focally undifferentiated thyroid carcinoma is an expression of the extreme end of the spectrum of differentiated thyroid carcinoma.
authors.affiliation: Shaukat Khanum Memorial Cancer Hospital and Research Centre, Clinic of Nuclear Medicine, Lahore, Pakistan, Phone: +92 346 5938557 E-mail: saimarz.dr@gmail.com.
authors.forename: Saima
authors.initials: S
authors.lastname: Riaz
authors.forename: Humayun
authors.initials: H
authors.lastname: Bashir
authors.forename: Aamna
authors.initials: A
authors.lastname: Hassan
authors.forename: Sajid
authors.initials: S
authors.lastname: Mushtaq
authors.forename: Arif
authors.initials: A
authors.lastname: Jamshed
authors.forename: Ahmad
authors.initials: A
authors.lastname: Murtaza