European Archives of Oto-Rhino-Laryngology

, Volume 276, Issue 5, pp 1541–1544 | Cite as

Fortuitous discovery of non-fluorocholine-fixing papillary carcinoma of vesicular variant of the thyroid

  • Nicolas GuignardEmail author
  • Guillaume Chambon
  • Benjamin Chambert
  • Yaser Najaf
  • Benjamin Lallemant
Short Communication



Characterization of thyroid nodules is crucial to propose surgical intervention for histological verification. Cervical ultrasound potentially combined with fine needle aspiration is recommended, and fluorocholine positron emission tomography (FCH-PET), commonly used in prostatic cancers, has been evaluated in the diagnosis of thyroid cancers in recent publications.


We present two cases of patients with multinodular thyroid and primary hyperparathyroidism. The preoperative assessment consisted of an ultrasound, a MIBI scintigraphy and an FCH-PET in favor of a parathyroid adenoma.


The imaging examinations pointed to a diagnosis of a parathyroid adenoma. In both cases, papillary thyroid carcinoma, missed by FCH-PET, was discovered incidentally at a distance from the parathyroid adenoma during the surgical procedure.


These are the first descriptions of thyroid papillary carcinoma without preoperative FCH-PET identification. These clinical cases are contrary to recent publications showing a benefit of this examination in the diagnosis of thyroid cancers.


18F-Choline PET-CT Differentiated thyroid cancer PET-CT Papillary thyroid carcinoma Thyroid incidentaloma 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Davies L, Welch HG (2006) Increasing incidence of thyroid cancer in the United States, 1973–2002. JAMA 295(18):2164–2167. CrossRefGoogle Scholar
  2. 2.
    Vaccarella S, Franceschi S, Bray F, Wild CP, Plummer M, Maso LD (2016) Worldwide thyroid-cancer epidemic? The increasing impact of overdiagnosis. N Engl J Med 375(7):614–617. CrossRefGoogle Scholar
  3. 3.
    Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, Pacini F et al (2016) 2015 American Thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association Guidelines Task Force on thyroid nodules and differentiated thyroid cancer. Thyroid 26(1):1–133. CrossRefGoogle Scholar
  4. 4.
    Michaud L, Balogova S, Burgess A, Ohnona J, Huchet V, Kerrou K, Lefèvre M et al (2015) A pilot comparison of 18F-fluorocholine PET/CT, ultrasonography and 123I/99mTc-SestaMIBI dual-phase dual-isotope scintigraphy in the preoperative localization of hyperfunctioning parathyroid glands in primary or secondary hyperparathyroidism: influence of thyroid anomalies. Medicine 94(41):e1701. CrossRefGoogle Scholar
  5. 5.
    Lalire P, Zalzali M, Garbar C, Bruna-Muraille C, Morland D (2016) Incidental detection of oxyphilic papillary thyroid carcinoma by 18F-fluorocholine PET/CT. Clin Nucl Med 41(6):512–513. CrossRefGoogle Scholar
  6. 6.
    Kumar RG, Kalathoorakathu RR et al (2017) Comparative effectiveness of ultrasonography, 99mTc-Sestamibi, and 18F-fluorocholine PET/CT in detecting parathyroid adenomas in patients with primary hyperparathyroidism. Clin Nucl Med 42(12):e491–e497. CrossRefGoogle Scholar
  7. 7.
    Hodolic M, Huchet V, Balogova S, Michaud L, Kerrou K, Nataf V, Cimitan M, Fettich J, Talbot J-N (2014) Incidental uptake of (18)F-fluorocholine (FCH) in the head or in the neck of patients with prostate cancer. Radiol Oncol 48(3):228–234. CrossRefGoogle Scholar
  8. 8.
    Thanseer NTK, Bhadada SK, Sood A, Parihar AS, Dahiya D, Singh P, Basher RK, Das A, Mittal BR (2018) Dual pathologies of parathyroid adenoma and papillary thyroid cancer on fluorocholine and fluorodeoxyglucose PET/CT. Nucl Med Mol Imaging 52(2):154–158. CrossRefGoogle Scholar
  9. 9.
    Eccles A, Challapalli A, Khan S, Barwick T, Mangar S (2013) Thyroid lymphoma incidentally detected by 18F-fluorocholine (FCH) PET/CT. Clin Nucl Med 38(9):755–757. CrossRefGoogle Scholar
  10. 10.
    Schillaci O, Calabria F, Tavolozza M, Cicciò C, Carlani M, Caracciolo CR, Danieli R, Orlacchio A, Simonetti G (2010) 18F-Choline PET/CT physiological distribution and pitfalls in image interpretation: experience in 80 patients with prostate cancer. Nucl Med Commun 31(1):39–45CrossRefGoogle Scholar
  11. 11.
    Paone G, Treglia G, Bongiovanni M, Ruberto T, Ceriani L, Giovanella L (2013) Incidental detection of Hürthle cell adenoma by 18F-Choline PET/CT scan in a patient with prostate cancer. Revista Espanola De Medicina Nuclear E Imagen Molecular 32(5):340–341. CrossRefGoogle Scholar
  12. 12.
    Treglia G, Giovannini E, Mirk P, Franco DD, Oragano L, Bertagna F (2014) A thyroid incidentaloma detected by 18F-Choline PET/CT. Clin Nucl Med 39(4):e267–e269. CrossRefGoogle Scholar
  13. 13.
    Aziz A-L, Courbon F, Dierickx LO, Pascal P, Zerdoud S (2015) Oncocytic adenoma of thyroid incidentally detected by 18F-fluorocholine PET/CT. J Nucl Med Technol 43(2):133–134. CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Centre hospitalo-universitaire de Nîmes, Service d’oto-rhino-laryngologieNîmesFrance
  2. 2.Centre hospitalo-universitaire de Nîmes, Service de médecine nucléaireNîmesFrance

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