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CC BY-NC-ND 4.0 · Ultrasound Int Open 2018; 04(02): E39-E44
DOI: 10.1055/a-0591-6163
Original Article
Eigentümer und Copyright ©Georg Thieme Verlag KG 2018

Can Ultrasound Alone Predict Papillary Thyroid Carcinoma with Desmoid-Type Fibromatosis? A Retrospective Analysis of 13 Cases, Focusing on the Stromal Area

Kumiko Tajiri
1   Kuma Hospital, Department of Clinical Laboratory, Kobe, Japan
,
Mitsuyoshi Hirokawa
2   Kuma Hospital, Department of Diagnostic Pathology and Cytology, Kobe, Japan
,
Ayana Suzuki
1   Kuma Hospital, Department of Clinical Laboratory, Kobe, Japan
,
Nami Takada
1   Kuma Hospital, Department of Clinical Laboratory, Kobe, Japan
,
Hisashi Ota
1   Kuma Hospital, Department of Clinical Laboratory, Kobe, Japan
,
Maki Oshita
1   Kuma Hospital, Department of Clinical Laboratory, Kobe, Japan
,
Mitsuhiro Fukushima
3   Kuma Hospital, Department of Surgery, Kobe, Japan
,
Kaoru Kobayashi
3   Kuma Hospital, Department of Surgery, Kobe, Japan
,
Akira Miyauchi
3   Kuma Hospital, Department of Surgery, Kobe, Japan
› Author Affiliations
Further Information

Publication History

received 04 October 2017
revised 21 February 2018

accepted 05 March 2018

Publication Date:
05 July 2018 (online)

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Abstract

Purpose

Papillary thyroid carcinoma with desmoid-type fibromatosis (PTC-DTF) is extremely rare. So far, only 4 cases describing the ultrasound findings of this variant have been reported. Here, we describe the ultrasound findings of 13 cases of PTC-DTF, focusing especially on the DTF area.

Materials and Methods

We retrospectively analyzed the clinical reports, ultrasound reports, and ultrasound photographs obtained from medical records at Kuma Hospital.

Results

The patients included 8 women and 5 men with a mean age of 47.9 years. The widest dimension of the nodules ranged from 16 to 79 mm (mean: 37.5 mm). The original ultrasound reports classified the nodules as either intermediate suspicion or high suspicion. A diagnosis of PTC was suspected in 12 nodules, and anaplastic carcinoma was suspected in 1 nodule. PTC-DTF presented with an irregularly shaped nodule (100%), taller-than-wide sign (84.6%), heterogeneous echogenicity (100%), no microcalcification (76.9%), and no or mild flow signal on Doppler (75.0%). The DTF area was identified in the ultrasound photographs of 8 nodules. DTF areas were generally heterogeneous (62.5%) and more hypoechoic (71.4%) than PTC areas. Microcalcification was not observed in the DTF areas. All of the DTF areas revealed no or mild flow signal. On ultrasound elastography, the DTF areas were not stiff, and they were more elastic than the PTC areas.

Conclusion

It is difficult to predict PTC-DTF using ultrasound alone, and B-mode ultrasonography is more reliable than ultrasound elastography in the ultrasound diagnosis of malignant thyroid nodules.

Key words

Papillary carcinoma - thyroid - ultrasound - Desmoid-type fibromatosis
 

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